Adjuvant Therapies for Chemotherapy for Medulloblastomas in Children

Radiation

• Standard risk: Radiation treatment for standard-risk disease in children consists of craniospinal radiation of 2340 cGy plus a boost of 5400 cGy to the primary site of the tumor. Initially this boost was to the whole posterior fossa, but, more recently, conformal fields around the primary site of the tumor at diagnosis with a margin have been recommended.
• High risk: Radiation treatment of high-risk medulloblastoma in children consists of craniospinal radiation of 3600 cGy plus a conformal boost to the posterior fossa of 5580 cGy and boosts to any metastases.
• Vincristine during radiation: Weekly vincristine, 1.5 mg/m2 (maximum, 2 g) IV, has generally been used during radiation, but there is some controversy about the need for it.