Gajjar A, Kühl J, Epelman S, Bailey C, Allen J
St. Jude Children's Research Hospital, 332 N. Lauderdale St., Memphis, TN 38105-2729, USA.
Childs Nerv Syst. 1999 Oct;15(10):554-62. doi: 10.1007/s003810050543.
Recent advances in neurosurgical techniques and diagnostic imaging capabilities have facilitated gross total resection and accurate staging of disease extent in a greater proportion of patients. The addition of chemotherapy to surgery and craniospinal radiation has improved the outcome of patients diagnosed with medulloblastoma. Long-term follow-up studies have documented the neuroendocrine and neuropsychological deficits seen in the survivors. This paper reviews key studies using all three modalities over the past two decades and presents on-going therapeutic strategies using a risk-adapted approach. Further areas of basic research and evolving data on studies in relapsed patients are also briefly discussed.
神经外科技术和诊断成像能力的最新进展使得更大比例的患者能够实现肿瘤全切并准确判断疾病范围。手术联合化疗及全脑全脊髓放疗改善了髓母细胞瘤患者的治疗效果。长期随访研究记录了幸存者出现的神经内分泌和神经心理缺陷。本文回顾了过去二十年使用这三种治疗方式的关键研究，并介绍了采用风险适应性方法的现行治疗策略。还简要讨论了基础研究的其他领域以及复发患者研究的不断变化的数据。
