Table 3.

Main studies about the treatment of average risk medulloblastoma patients

Study	Therapy	Results
Packer et al	reduced-dose craniospinal radiation therapy (23.4 Gy) and 55.8 Gy of local radiation therapy plus concomitant vincristine chemotherapy and adjuvant lomustine, vincristine, and cisplatin chemotherapy	PFS 86% ± 4% at 3 years and 79% ± 7% at 5 years
Padovani et al	radiotherapy vs radio + chemotherapy	standard-risk disease could be treated with radiochemotherapy, reducing doses of RT
Greenberg et al	radiotherapy + POG protocol/Packer protocol	adults on POG protocol seemed to have less nonhematologic toxicity; on the Packer protocol appeared to have shorter median survival and greater toxicity than did children
Friedrich et al	radiotherapy + chemotherapy with lomustine, vincristine and cisplatin	EFS4 and OS4 were 68% ± 7% and 89% ± 5%. Peripheral neuropathy (74%) and haematotoxicity (55%) during maintenance chemotherapy appear to be more common in adults than in children
Beier et al (NOA-07)	craniospinal irradiation with vincristine, followed by 8 cycles of cisplatin, lomustine, and vincristine	radio-polychemotherapy did lead to considerable toxicity and a high amount of dose reductions
Kortmann et al	ARM 1: neoadjuvant chemotherapy with ifosfamide, etoposide, intravenous high-dose methotrexate, cisplatin, and cytarabine before radiotherapy ARM 2: immediate postoperative radiotherapy, with concomitant vincristine followed by 8 cycles of maintenance chemotherapy consisting of cisplatin, CCNU, and vincristine	maintenance chemotherapy would seem to be more effective in low-risk medulloblastoma Neoadjuvant chemotherapy was accompanied by increased myelotoxicity of the subsequent radiotherapy