Classification and Treatment of Pediatric Medulloblastoma

Abstract

  Medulloblastoma, one of the most common pediatric brain tumors, is also as well known as a leading model in the development of molecular classification systems. In the 2021 WHO classification of central nervous system tumors, medulloblastoma is the only tumor in which molecular classification was adopted in place of histopathological diagnosis. In general, the molecular classification categorizes medulloblastoma into four sub-groups based on gene expression profiles or genetic alterations ; WNT, SHH, Group3, and Group4. It is important that this molecular classification reflects not only the clinical characteristics of tumors, but also their related prognosis in patients with medulloblastoma. Treatment of medulloblastoma is performed according to clinical risk stratification, which is made based on the patients' age, the presence of residual tumors, and the presence of metastatic/disseminated lesions. By integrating molecular information with these clinical risk factors, patients with medulloblastoma could receive more appropriate treatment. The optimization of treatment strategies is expected to improve the prognosis of medulloblastoma patients, along with functional aspects. Treatment trends of medulloblastoma should be monitored, and surgical treatment should be provided to improve long-term survival.