Current Environment:

Children with medulloblastoma who come to Dana-Farber/Boston Children's Cancer and Blood Disorders Center are treated by brain tumor specialists and pediatric subspecialists with expertise in treating these rare but invasive tumors. Under a microscope, medulloblastomas appear similar to other brain tumors, such as pineoblastomas and primitive neuroectodermal tumors, but medulloblastomas behave differently and may require different treatment plans. The specialists in our Medulloblastoma Program have the expertise required to accurately diagnose these tumors and provide a personalized treatment plan tailored to the needs of each individual patient.

Dana-Farber/Boston Children's patients who come for treatment at our Medulloblastoma Program have access to the broadest set of pediatric and oncologic expertise available. The breadth of our expertise allows us to assemble a team of experts to meet the specific needs of our patients.

At the core of the treatment team is a neuro-oncologist with expertise in treating medulloblastoma. Many of our brain tumor specialists are also active researchers, so our patients have access to clinical trials and advanced treatments.

How we approach medulloblastomas

Treatments for medulloblastoma are based on several factors, including the child’s age, overall health, and medical history; type, location, and size of the tumor; the extent of disease; and the doctor’s expectations for how the tumor will behave.

Neurosurgery is almost always used to remove the tumor and relieve the symptoms of hydrocephalus, a build-up of cerebrospinal fluid that causes increased pressure in the brain, a hallmark of these cancers. During surgery, an intra-operative MRI is used to help ensure that as much of the tumor is removed as safely as possible. An endoscopic third ventriculostomy (ETV) or a ventriculo-peritoneal (VP) shunt may also be used to relieve pressure. Following surgery, radiation therapy and/or chemotherapy may be used to kill off any remaining cancer cells. This may include the use of new biologic agents that target specific mutations in these tumors.

Research and clinical trials

Our clinical research program offers unique access to clinical trials in which children can receive research-focused medulloblastoma treatments. We are consistently one of the most highly funded pediatric brain tumor centers in the United States. A major focus of our research program is the rapid translation of scientific discoveries to the bedside to benefit patients. Through their research, our physician-scientists found they could group medulloblastomas into specific subtypes, each with a unique fingerprint, which provides a first step to taking a personalized medicine approach to treating these tumors. Based on these results, specific molecularly targeted clinical trials for patients with two of these subgroups are under way.