Medulloblastoma: Systemic Chemotherapy and Future Applications of Chemoradiotherapy

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Abstract
Medulloblastoma is the most common malignant brain tumor in children. Prognosis remains guarded in patients who at diagnosis are very young, have craniospinal metastatic disease, or after resection, have residual disease. Treatment incorporates chemotherapy and radiation therapy. Cancer survivors often have life-altering treatment effects. This chapter reviews clinical trials over the years and the efforts to improve survival and minimize sequelae along with challenges in performing clinical trials. Quality assurance of the radiation therapy provided worldwide monitors compliance. Advances in the risk stratification and targeted treatment based on the genomics and biology of medulloblastoma are highlighted in recent clinical trials. Through chemotherapy aligned with specific biomarkers, sophisticated radiation therapy strategies, and continued quality assurance, the future vision of managing medulloblastoma is presented.

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