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International Journal of Surgical Oncology
Volume 2012, Article ID 245385, 6 pages
Clinical Study

Metastatic Medulloblastoma in Childhood: Chang's Classification Revisited

1Department of Pediatric and Adolescent Oncology, Institute Gustave Roussy, 114 rue Edouard Vaillant, 94805 Villejuif, France
2Department of Oncology, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
3Department of Pediatric Hematology/Oncology, CHU Amiens, Amiens, France
4Biostatistics and Epidemiology Unit, Institute Gustave Roussy, Villejuif, France
5Department of Radiology, Institute Gustave Roussy, Villejuif, France

Received 1 May 2011; Revised 29 June 2011; Accepted 3 July 2011

Academic Editor: Russell Lonser

Copyright © 2012 Christelle Dufour et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Purpose. To correlate the radiological aspects of metastases, the response to chemotherapy, and patient outcome in disseminated childhood medulloblastoma. Patients and Methods. This population-based study concerned 117 newly diagnosed children with disseminated medulloblastoma treated at the Institute Gustave Roussy between 1988 and 2008. Metastatic disease was assessed using the Chang staging system, their form (positive cerebrospinal fluid (CSF), nodular or laminar), and their extension (positive cerebrospinal fluid, local, extensive). All patients received preirradiation chemotherapy. Results. The overall survival did not differ according to Chang M-stage. The 5-year overall survival was 59% in patients with nodular metastases compared to 35% in those with laminar metastases. The 5-year overall survival was 76% in patients without disease at the end of pre-irradiation chemotherapy compared to 34% in those without a complete response ( ). Conclusions. Radiological characteristics of metastases correlated with survival in patients with medulloblastoma. Complete response to sandwich chemotherapy was a strong predictor of survival.