Treatment by Subtype

Treatment for medulloblastoma varies based on the subtype that is diagnosed. The four subtypes at diagnosis are:

• WNT-activated
• SHH-activated
• Group 3 (non-WNT/non-SHH)
• Group 4 (non-WNT/non-SHH)

In addition to subtype, other factors affect treatment decisions. This can include the patient’s age, if or how much the cancer has spread (metastasized), and the standard protocols followed by the treating facility.

Treatment approaches such as the number of rounds of chemotherapy done and what drugs are used may vary from facility to facility.

Overview of Medulloblastoma Treatment Protocols

Below are listed general treatment protocols that are typically followed for each subtype of medulloblastoma.

WNT

• Least common subtype; account for about 10% of diagnoses
• Best prognosis of the four subtypes
• Tends not to spread
• Most often diagnosed in older kids and teens, rarely in infants
• Typical treatment sequence:
  1. Surgery
  2. Radiation
  3. Chemotherapy

SHH

• Account for about 30% of diagnoses
• Most often found in infants and adults
• Tends not to spread
• Typical treatment sequence:
  1. Surgery
  2. Chemotherapy/radiation
  3. Potentially chemotherapy only depending on facility/age of patient

Group 3

• Account for about 25% of diagnoses
• Occurs more in males than females
• Most often found in infants and children, rarely in teens, very rarely in adults
• Higher chance of spreading (metastasis) to spine
• Typical treatment sequence:
  1. Surgery
  2. Radiation needed but some facilities may hold off until child is 3 or older
  3. Chemotherapy

Group 4

• Account for about 35% of diagnoses
• Poor prognosis in adults, intermediate in children
• Occurs more in males than females
• Metastasis occurs often
• Typical treatment sequence:
  1. Surgery
  2. Radiation is needed but some facilities may hold off until child is 3 or older
  3. Chemotherapy

Stem cell transplant after chemotherapy is also an option offered at some treatment facilities.