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Medulloblastoma and other primary malignant neuroectodermal tumors of the CNS. The effect of patients' age and extent of disease on prognosis.

✓ Studies to evaluate the extent of their disease were performed on 30 children with newly diagnosed malignant neuroectodermal tumors of the central nervous system, including 25 children with medulloblastomas. The studies consisted of postoperative computerized tomography scanning, cerebrospinal fluid (CSF) cytology, myelography, and bone marrow aspiration. In 11 patients (36%) one or more of these studies was positive, indicating disease dissemination (Group 1), and in 19 (64%) all four studies were negative (Group 2). The CSF cytology was positive for malignant cells in all 11 Group 1 patients; myelograms indicated subclinical filling defects in nine, and the bone marrow aspirate from two patients revealed extrinsic cells. All patients received a conventional course of neuraxis radiation therapy as tolerated, and some also received chemotherapy. Patients with abnormal myelograms received additional radiation to areas of identifiable subarachnoid disease. The median survival time in Group 1 was 12 months...