Overview of Treatment of Pediatric Medulloblastoma

Medulloblastoma is the most common brain tumor in children. Its current treatment consists of surgery, irradiaton, and chemotherapy with their significant short term and long term toxicity. Intensity of current therapy, determined by clinical risk stratification of the tumor (age of patient, extent of tumor resection and presence of metastasis), results in a markedly different overall survival rate depending on different risk groups (average-, high-risk and young patients). The potentials of present therapeutic approach seems to have reached its plateau. Recently, a new molecular stratification of medulloblastoma was introduced defining four different subgroups based on the affected molecular pathway in tumorigenesis of medulloblastoma (SHH, Wnt, Group C, and D). This new classification presumably will open new possibilities of individualized therapy and application of new drugs, based on the important molecular alteration of individual medulloblastoma cases. Here we summarize the current therapeutical approaches and existing new therapeutic attempts. Although there already are several new experimental attempts to treat medulloblastoma beyond conventional therapy, a really effective new therapy is still to be discovered.