Received: 29 March 1999 Abstract The objective of this study was to present survival data and out- come status in the long-term survi- vors of a consecutive series of 111 children and young adults treated for posterior fossa medulloblastoma in our departments from 1960 to 1997. The total surgical mortality was 13%. The surgical mortality rate de- clined significantly during the time period overall, from 23% before 1970 to 0% after 1990. The 5-year survival rate for patients treated be- tween 1960 and 1973 was 0%, while 5-year survival for patients treated after the introduction of systematic craniospinal radiation in 1974 was 53% . Thirty-four patients were alive at the close of this study, with a mean observation time of 13.5 years. Over half, 61%, of the patients had one or more major deficits/problems with respect to learning ability, pow- er of locomotion, sociability, hobbies and relationships with the opposite sex. A younger age at the time of treatment was correlated with larger deficits/problems in these variables. The correlation between young age at the time of treatment and short fi- nal height was significant. The fre- quency of a second neoplasm was 14%. In all but 3 cases the major cause of permanent deficits/prob- lems was radiation therapy. Key words Brain neoplasm · Medulloblastoma · Radiation therapy · Survival · Long-term sequelae Child’s Nerv Syst (1999) 15:451–456 © Springer-Verlag 1999 ORIGINAL PAPER Eirik Helseth Bernt Due-Tønnessen Finn Wesenberg Knut Lote Tryggve Lundar Posterior fossa medulloblastoma in children and young adults (0–19 years): survival and performance Introduction Medulloblastomas are highly malignant tumors and not curable by surgery alone [6]. No significant improve- ment in survival was achieved for these patients until the introduction of systematic craniospinal radiotherapy with tumor doses of 50 Gy or more and craniospinal axis dos- es of 30 Gy or more [12, 15]. The effect of chemothera- py on long-time survival is so far only marginal [1, 5, 10, 16]. Five-year survival for these patients is now reported to be 50–60% [7, 11, 12, 14]. However, as the number of children surviving has increased, attention has been drawn to treatment-induced sequelae, such as intellectual impairment, endocrine dysfunction, social isolation and secondary neoplasms [4, 11]. The sequelae caused by surgery are evident very soon after the surgical proce- dure, and improvement takes place during the following 12–18 months. In contrast, the serious side effects of cra- niospinal radiation will evolve slowly over years [11]. The objective of this study was to present survival data and outcome status in long-term survivors out of a con- secutive series of 111 children treated in our departments from 1960 to 1997 for posterior fossa medulloblastoma. Patients and methods From January 1960 to December 1997, 111 children and young adults (0–19 years) were treated for histologically verified posterior fossa medulloblastoma at The National Hospital and The Norwe- gian Radium Hospital in Oslo, Norway. Throughout this time the surgical goal was the maximal possible resection of the tumor with optimal neurological outcome. Persistent hydrocephalus after tumor removal was treated with a ventriculo-atrial or a ventriculo-perito- neal shunt. Radiation and chemotherapy protocols have varied dur- ing this time period. From 1960 to 1973 radiation therapy was non- E. Helseth ( ✉ ) · B. Due-Tønnessen T. Lundar Department of Neurosurgery, The National Hospital, N-0027 Oslo, Norway Tel.: +47-22-867010 Fax: +47-22-867189 F. Wesenberg Department of Pediatrics, The National Hospital, Oslo, Norway K. Lote Department of Radiation Oncology, The Norwegian Radium Hospital, Oslo, Norway