Primary malignant cerebellar astrocytomas in children: a signal for postoperative craniospinal irradiation

Malignant astrocytomas of the cerebellum are rare tumors which can occur in children. During the last 20 years, 13 patients with this diagnostic received postoperative irradiation at the University of Rochester Cancer Center. The median age of patients was 9.8 years, the male-to-female ratio was 1.6, and the median survival was 20 months. Six patients treated with cranial irradiation (CI) had a median survival of 10 months and 5/6 developed spinal subarachnoid metastases. Seven patients treated with craniospinal irradiation (CSI) had a median survival of 48 months; none has developed spinal metastases. The recommended treatment with CSI resembles that of medulloblastoma, as it is tailored to the spread and behaviorial patterns of these rare neoplasms