Display options
Share it on

Neurooncol Pract. 2017 Sep;4(3):138-150. doi: 10.1093/nop/npx011. Epub 2017 Aug 11.

Case-based review: pediatric medulloblastoma.

Neuro-oncology practice

Cassie N Kline, Roger J Packer, Eugene I Hwang, David R Raleigh, Steve Braunstein, Corey Raffel, Pratiti Bandopadhayay, David A Solomon, Mariam Aboian, Soonmee Cha, Sabine Mueller

Affiliations

  1. Division of Hematology/Oncology, Department of Pediatrics, University of California, San Francisco, 550 16th Street, 4th Floor, San Francisco, CA 94158 (C.K., S.M.); Center for Neuroscience and Behavioral Medicine, Children's National Medical Center, 111 Michigan Avenue NW, Washington, DC 20010 (R.P.); Brain Tumor Institute, Children's National Medical Center, 111 Michigan Avenue NW, Washington, DC 20010 (R.P., E.H.); Division of Hematology/Oncology, Center for Cancer and Blood Disorders, Children's National Health Systems, 111 Michigan Avenue NW, Washington, DC 20010 (R.P., E.H.); Department of Radiation Oncology, University of California, 1825 4th Street, San Francisco, San Francisco, CA 94158 (D.R., S.B.); Department of Neurological Surgery, University of California, San Francisco, 505 Parnassus Avenue, M779, San Francisco, CA 94143 (C.R., S.M.); Dana-Farber/Boston Children's Cancer and Blood Disorders Center, 450 Brookline Avenue, Boston, MA 02215 (P.B.); Department of Pediatrics, Harvard Medical School, Boston, MA 02215 (P.B.); Broad Institute of MIT and Harvard, 415 Main Street, Cambridge, MA 02142 (P.B.); Division of Neuropathology, Department of Pathology, University of California, San Francisco, 505 Parnassus Avenue, M551, Box 0102 San Francisco, CA 94143 (D.S.); Department of Radiology, University of California, San Francisco, 550 Parnassus Avenue, M327, San Francisco, CA 94143 (M.A., S.C.); Department of Neurology, Neurosurgery and Pediatrics, University of California, San Francisco, 550 Sandler Neurosciences, 625 Nelson Rising Lane, 402B, Box 0434, San Francisco, CA 94158 (S.M.).

PMID: 29692919 PMCID: PMC5909805 DOI: 10.1093/nop/npx011

Abstract

Medulloblastoma is the most common malignant brain tumor affecting children. These tumors are high grade with propensity to metastasize within the central nervous system and, less frequently, outside the neuraxis. Recent advancements in molecular subgrouping of medulloblastoma refine diagnosis and improve counseling in regards to overall prognosis. Both are predicated on the molecular drivers of each subgroup-WNT-activated, SHH-activated, group 3, and group 4. The traditional therapeutic mainstay for medulloblastoma includes a multimodal approach with surgery, radiation, and multiagent chemotherapy. As we discover more about the molecular basis of medulloblastoma, efforts to adjust treatment approaches based on molecular risk stratification are under active investigation. Certainly, the known neurological, developmental, endocrine, and psychosocial injury related to medulloblastoma and its associated therapies motivate ongoing research towards improving treatment for this life-threatening tumor while at the same time minimizing long-term side effects.

Keywords: chemotherapy; medulloblastoma; radiation; risk stratification; targeted therapy

References

  1. J Clin Oncol. 1999 Oct;17(10):3234-7 - PubMed
  2. Lancet Oncol. 2005 Aug;6(8):573-80 - PubMed
  3. J Clin Oncol. 1999 Mar;17(3):832-45 - PubMed
  4. Int J Radiat Oncol Biol Phys. 2004 Mar 1;58(3):727-34 - PubMed
  5. Acta Neuropathol. 2016 Jun;131(6):803-20 - PubMed
  6. J Neurooncol. 2013 Nov;115(2):153-60 - PubMed
  7. Cancer. 2014 Dec 1;120(23):3731-7 - PubMed
  8. Neuro Oncol. 2013 Jan;15(1):97-103 - PubMed
  9. J Clin Oncol. 2011 Apr 10;29(11):1424-30 - PubMed
  10. J Neurosurg. 1990 Apr;72(4):572-82 - PubMed
  11. Int J Radiat Oncol Biol Phys. 2008 Mar 1;70(3):782-7 - PubMed
  12. Oncotarget. 2016 Aug 16;7(33):53881-53894 - PubMed
  13. Eur J Cancer. 1990 Apr;26(4):464-9 - PubMed
  14. Int J Radiat Oncol Biol Phys. 2013 Jul 15;86(4):649-55 - PubMed
  15. J Clin Oncol. 2003 Sep 1;21(17):3255-61 - PubMed
  16. Neuro Oncol. 2010 Dec;12(12):1311-7 - PubMed
  17. Childs Nerv Syst. 2007 Aug;23 (8):887-90 - PubMed
  18. J Neurosurg Pediatr. 2015 Jan;15(1):4-11 - PubMed
  19. Neurosurgery. 2004 Dec;55(6):1280-8; discussion 1288-9 - PubMed
  20. Acta Neuropathol. 2016 Jun;131(6):821-31 - PubMed
  21. J Child Neurol. 2009 Dec;24(12):1526-35 - PubMed
  22. Int J Radiat Oncol Biol Phys. 2004 Mar 15;58(4):1184-93 - PubMed
  23. Cancer Cell. 2014 Mar 17;25(3):393-405 - PubMed
  24. Neuro Oncol. 2011 Jun;13(6):669-79 - PubMed
  25. J Clin Oncol. 2013 Oct 1;31(28):3494-500 - PubMed
  26. Cancer. 2011 Jul 15;117(14):3262-7 - PubMed
  27. Acta Neuropathol. 2012 Apr;123(4):465-72 - PubMed
  28. Am J Med Genet A. 2011 Sep;155A(9):2091-7 - PubMed
  29. Clin Nucl Med. 2009 Aug;34(8):530-2 - PubMed
  30. Cancer Cell. 2016 Mar 14;29(3):311-323 - PubMed
  31. J Clin Oncol. 2001 Aug 1;19(15):3470-6 - PubMed
  32. Med Pediatr Oncol. 1995 Sep;25(3):166-78 - PubMed
  33. Pediatr Neurosurg. 1994;20(4):240-7 - PubMed
  34. Oncotarget. 2014 May 15;5(9):2355-71 - PubMed
  35. AJNR Am J Neuroradiol. 2006 Jun-Jul;27(6):1362-9 - PubMed
  36. J Clin Oncol. 2012 Sep 10;30(26):3181-6 - PubMed
  37. J Clin Oncol. 2013 Aug 10;31(23):2927-35 - PubMed
  38. Neuroradiology. 2011 Jun;53(6):387-96 - PubMed
  39. J Neurooncol. 2014 Feb;116(3):617-23 - PubMed
  40. J Neurosurg. 1991 Mar;74(3):433-40 - PubMed
  41. J Clin Oncol. 2006 Sep 1;24(25):4202-8 - PubMed
  42. Cancer Cell. 2016 Apr 11;29(4):508-522 - PubMed
  43. J Clin Oncol. 2010 Nov 20;28(33):4961-8 - PubMed
  44. Acta Neuropathol. 2007 Aug;114(2):97-109 - PubMed
  45. Neuro Oncol. 2016 Nov;18(11):1548-1558 - PubMed
  46. AJR Am J Roentgenol. 2013 Apr;200(4):895-903 - PubMed
  47. J Clin Oncol. 2011 Apr 10;29(11):1400-7 - PubMed
  48. J Clin Oncol. 2005 Apr 1;23(10):2256-63 - PubMed
  49. Oncotarget. 2013 Nov;4(11):2080-95 - PubMed
  50. J Neurosurg Pediatr. 2010 Apr;5(4):329-34 - PubMed
  51. Cancer. 1980 Feb 15;45(4):666-9 - PubMed
  52. J Clin Oncol. 2014 Dec 20;32(36):4155-61 - PubMed
  53. Neurosurgery. 2000 Oct;47(4):888-901 - PubMed
  54. Pediatr Blood Cancer. 2007 Oct 15;49(5):723-6 - PubMed
  55. Cancer. 1979 Jan;43(1):41-5 - PubMed
  56. J Clin Oncol. 2015 Aug 20;33(24):2646-54 - PubMed
  57. Pediatr Neurol. 2015 Jul;53(1):31-46 - PubMed
  58. Pediatr Int. 2013 Jun;55(3):305-9 - PubMed
  59. N Engl J Med. 1995 Mar 30;332(13):839-47 - PubMed
  60. Pediatr Blood Cancer. 2009 Jan;52(1):60-4 - PubMed
  61. Am J Hum Genet. 2012 Sep 7;91(3):520-6 - PubMed
  62. Nature. 2012 Aug 2;488(7409):100-5 - PubMed
  63. J Clin Oncol. 2005 Oct 20;23(30):7621-31 - PubMed
  64. AJNR Am J Neuroradiol. 2000 Oct;21(9):1757-65 - PubMed
  65. Ann Neurol. 1988 Oct;24(4):503-8 - PubMed
  66. Nature. 2010 Dec 23;468(7327):1095-9 - PubMed
  67. Cancer. 2011 Nov 1;117(21):4977-82 - PubMed
  68. J Clin Oncol. 1999 Jul;17(7):2127-36 - PubMed
  69. J Child Neurol. 2016 Feb;31(2):237-54 - PubMed
  70. J Clin Oncol. 2011 Apr 10;29(11):1408-14 - PubMed
  71. J Clin Neurosci. 2016 Aug;30:93-97 - PubMed
  72. Clin Cancer Res. 2014 Feb 15;20(4):912-25 - PubMed
  73. Pediatr Blood Cancer. 2013 Sep;60(9):1408-10 - PubMed
  74. J Clin Oncol. 2003 Apr 15;21(8):1581-91 - PubMed
  75. Int J Radiat Oncol Biol Phys. 2000 Jan 15;46(2):269-79 - PubMed
  76. Lancet Oncol. 2006 Oct;7(10):813-20 - PubMed
  77. J Neurooncol. 2017 Jan;131(2):359-368 - PubMed
  78. Pediatr Blood Cancer. 2008 Jun;50(6):1169-75 - PubMed
  79. Childs Nerv Syst. 2007 May;23(5):555-8 - PubMed
  80. N Engl J Med. 1993 Jun 17;328(24):1725-31 - PubMed
  81. J Neurosurg. 1994 Nov;81(5):690-8 - PubMed
  82. J Clin Oncol. 2003 Aug 15;21(16):3079-83 - PubMed
  83. Childs Nerv Syst. 2011 Mar;27(3):355-63 - PubMed
  84. Radiographics. 2003 Nov-Dec;23 (6):1613-37 - PubMed
  85. Int J Radiat Oncol Biol Phys. 2016 Mar 15;94(4):800-7 - PubMed
  86. J Neurosurg. 1989 May;70(5):707-13 - PubMed
  87. J Clin Oncol. 2000 Aug;18(16):3004-11 - PubMed
  88. AJNR Am J Neuroradiol. 2014 Jul;35(7):1263-9 - PubMed
  89. N Engl J Med. 2005 Mar 10;352(10):978-86 - PubMed
  90. Clin Neurosurg. 1983;30:278-85 - PubMed
  91. Arch Neurol. 1985 Jul;42(7):697-8 - PubMed
  92. Eur J Cancer. 2010 Jan;46(1):120-33 - PubMed
  93. J Neurosurg. 1994 Jun;80(6):1004-10 - PubMed
  94. Radiology. 1969 Dec;93(6):1351-9 - PubMed
  95. Neuro Oncol. 2009 Apr;11(2):201-10 - PubMed
  96. J Clin Oncol. 2001 Jan 15;19(2):480-7 - PubMed
  97. Acta Neuropathol. 2012 Apr;123(4):473-84 - PubMed
  98. Nature. 2012 Aug 2;488(7409):106-10 - PubMed

Publication Types

Grant support