Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Pediatr Blood Cancer. 2010 Apr;54(4):635-7. doi: 10.1002/pbc.22372.
In early childhood medulloblastoma, three distinct treatment strategies are currently used by different national groups to improve survival rates and to delay or avoid craniospinal radiotherapy: (1) systemic chemotherapy and high-dose chemotherapy, followed by radiotherapy at relapse; (2) systemic and intraventricular chemotherapy; (3) systemic chemotherapy and local conformal radiotherapy. A role for high-dose chemotherapy to delay or avoid craniospinal radiotherapy as a part of multimodal treatment strategies, especially in young children with metastatic or postoperative residual disease, has been recognized by different co-operative groups. Clinical and histological factors such as nodular-desmoplastic variants are considered as important prognostic factors for risk-adapted treatment recommendations.
在儿童期髓母细胞瘤中，不同的国家治疗组目前采用三种不同的治疗策略来提高生存率并延迟或避免全脑全脊髓放疗：（1）全身化疗和大剂量化疗，随后在复发时进行放疗；（2）全身和脑室内化疗；（3）全身化疗和局部适形放疗。高剂量化疗在多模式治疗策略中延迟或避免全脑全脊髓放疗的作用已被不同的合作组所认可，特别是对于有转移或术后残留病灶的幼儿。临床和组织学因素，如结节-硬化型变异，被认为是风险适应治疗建议的重要预后因素。
