Medulloblastomas in Pediatric and Adults

MedulloblastomaMedulloblastoma is the primary malignantMalignant embryonic tumor of the cerebellumCerebellum and the most common malignantMalignant tumor of childhood, accounting up to 25% of all CNS tumors in children, but is extremely rare in adults. Despite the fact that medulloblastomasMedulloblastoma are one of the most malignantMalignant human tumors, it is worthy to note that a great breakthrough has been achieved in our understanding of oncogenesisOncogenesis and the development of real methods of treatment. The main objective of surgical treatment is a maximum resection of tumor with minimal impairment of neurological functions, in order to reduce the volume, remove tumor tissue, get the biopsyBiopsy, and restore the cerebrospinal fluidCerebrospinal fluid (CSF) flow. The progress of surgical techniques (using a microscopeMicroscope, ultrasoundUltrasound suction), anesthesiology, and intensive care has significantly decreased surgical mortalityMortality and increased radicality of tumor removal. Postoperative mortalityMortality is less than one percent in most studies, while neurological complicationsComplication have been reported between 5–10%. RadiotherapyRadiotherapy is the main method of treatment in patients older than 3 years, which dramatically improved the recurrenceRecurrence-free survivalSurvival. Nevertheless, the radiation therapyRadiation therapy without systemic chemotherapyChemotherapy leads to a high risk of systemic metastasesMetastases. After the role of chemotherapyChemotherapy was statistically proven, investigations of the optimal combination of different chemotherapy regimens continued around the world. Currently, 80% of patients can already be cured, however, the quality of lifeQuality of Life (QoL) of patients in the long-term period remains quite low, which depends on many factors including endocrinological, cognitiveCognitive, neurological, and otoneurologic aspects. Thus, the main strategic goal of the development of neuro-oncology is to reduce the doses of radiation therapyRadiation therapy to the CNS and the main task of international research is to optimize existing protocols and develop fundamentally new ones based on molecular geneticGenetics research in order to improve the quality of life.