The most effective treatment for medulloblastoma is a combination of therapies that include surgery, radiation treatment and chemotherapy. Complete surgical removal of the tumor is important and is usually the first step in treatment. This is usually followed by radiation treatment to the entire brain and spine in older patients, followed by several months of chemotherapy.

Standard treatment for very young children — often defined as children less than 3 years old — includes surgical removal and chemotherapy. The use of radiation in this young age group is controversial, but some doctors are increasingly using radiation restricted to the area of the tumor. Because these young patients cannot tolerate whole brain and spine radiation, increasingly intensive doses of chemotherapy are being tested, including high-dose chemotherapy with autologous stem cell rescue, a form of bone marrow transplant.

With aggressive treatment, many medulloblastoma patients can be cured of the cancer. For patients 3 years or older, with "average risk" disease (defined as compete removal of the tumor and no signs of tumor spread to other parts of the central nervous system and body), who are treated with a combination of complete surgical removal of the tumor, radiation and chemotherapy, more than 80 percent can be cured.

Patients with "high risk" disease (the tumor has spread or cannot be completely removed with surgery) can still be cured, but the cure rates are lower. Treatment for younger patients, who are more prone to complications from extensive radiation treatment, is evolving. The goal is to identify effective strategies that will hopefully spare the patient the long-term complications of extensive radiation to the brain.

Reviewed by health care specialists at UCSF Benioff Children's Hospital.

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