Treatment controversies in medulloblastoma

Medulloblastoma, the most common primary malignant brain tumor in children, is a radiosensitive and chemosensitive tumor. Nevertheless, medulloblastoma remains a management challenge for the clinical oncologist, because the optimal sequence and dosage for each treatment modality has not yet been defined. In addition, effective management strategies for medulloblastoma may result in profound neuroendocrine and neuropsychologic sequelae. In this article, we review the clinical and biologic prognostic factors for classifying medulloblastoma, current strategies for the management of this disease, and potential strategies to prevent or minimize long-term treatment sequelae.