Medulloblastoma (Cerebellar PNET)

Information about pediatric medulloblastoma treatment, clinical trials, and research from Texas Children's Cancer Center. The Texas Children's Cancer Center Brain Tumor Program and the Brain Tumor Treatment Team treats patients with Medulloblastoma (Cerebellar PNET).

How common is Medulloblastoma?

Medulloblastoma is the most common malignant tumor of the brain in children. It usually affects children less than 10 years of age, but can occur in teenagers and young adults. 

What are the symptoms of Medulloblastoma?

Common symptoms in a child with medulloblastoma include: 

• Headaches
• Vomiting
• Difficulty in walking or maintaining balance
• Clumsiness
• Worsening handwriting
• Visual changes

How is medulloblastoma diagnosed?

The diagnosis of medulloblastoma is suspected when an MRI or CT scan of the brain reveals a tumor (mass) that is located in the back of the brain. A small percentage of children may also have evidence of tumor spread to other parts of the brain, the spinal cord, or the cerebrospinal fluid (clear fluid around the brain and spinal cord). Tumor spread is detected through MRIs of the brain and spinal cord. In addition, several weeks after surgery a lumbar puncture is performed in order to evaluate the cerebrospinal fluid. Surgery is required to confirm the diagnosis. 

What is the treatment for medulloblastoma? 

Treatment for medulloblastoma usually involves surgery, radiation therapy, and chemotherapy as outlined below:

Surgery. Surgery is the initial step in the treatment of medulloblastoma. Your child’s neurosurgeon will attempt to remove all of the tumor or as much as is safely possible.

Radiation therapy. Radiation to the brain and spine is usually started within one month of surgery. The dose of radiation depends on the initial tumor stage at the time of diagnosis. If you have a very young children or infant, your doctor may recommend a delay in radiation.

Chemotherapy. Following a rest period of 5-6 weeks after the completion of radiotherapy, chemotherapy is given. In children younger than 3 years of age chemotherapy is given initially and radiation therapy is deferred

Challenges to be addressed

Medulloblastoma is a curable disease for the majority of children. However, there are challenges that remain. It is not always possible to accurately predict which children will not benefit from current treatment approaches. Researchers at Texas Children's Cancer Center are studying the pathways for the development of this tumor that may shed light on the characteristics of the tumor in an individual child and thereby give us tools to predict the outcome and tailor therapy. Current treatments although effective, have a significant impact on the learning abilities of the child and also affect the hormonal status of the child resulting in short stature and thyroid disorders. Innovative research at TXCH in collaboration with other investigators around the country can lead to treatments that destroy the tumor but leave the individual intact to function normally. Innovative radiotherapy techniques including Intensity Modulated Radiation Therapy (IMRT) decrease the volume of normal brain structures that are exposed to high doses of radiation therapy while providing adequate radiation to the affected areas. Such techniques are likely to reduce the long-term side effects of radiation therapy. 

About PDQ and This Cancer Information Summary

PDQ is the National Cancer Institute's (NCI's) comprehensive cancer information database. PDQ is provided as a service of the NCI. The NCI is part of the National Institutes of Health, the federal government's focal point for biomedical research. The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. The PDQ cancer information summaries are developed by cancer experts and reviewed regularly.