Hyperfractionated Versus Conventionally Fractionated Radiotherapy in Standard Risk Medulloblastoma

Inclusion Criteria:

• Age at diagnosis at least 4 years or 5 years (according to the policy of the NationalBrain Tumour Group) and less than 22 years.
• Histologically proven medulloblastoma, including the following variants(WHOclassification - 2000): classic medulloblastoma, nodular / desmoplasticmedulloblastoma, melanotic medulloblastoma, medullomyoblastoma No CNS metastasis onMRI - supratentorial, arachnoid of the posterior fossa or spine.
• No clinical evidence of extra-CNS metastasis
• No tumour cells on the cytospin of lumbar CSF. Central Review of CSF cytology isrecommended but not mandatory. It will be left to national policy.
• Radiotherapy to start no more than 40 days after surgery.
• Ability to receive twice daily radiotherapy.
• Vital functions within normal range for their age group.
• CTC grades < 2 for liver, renal, haematological and audiological function.
• No medical contraindication to radiotherapy or chemotherapy.
• Written informed consent (and patient assent where appropriate) according to the lawsof each participating country. Written informed consent should also be sought forbiological studies.
• National and local ethical committee approval according to the laws of eachparticipating country (to include approval for biological studies).

Exclusion Criteria:

• One of the inclusion criteria is lacking.
• Brainstem or supratentorial primitive neuroectodermal tumour.
• Atypical teratoid rhabdoid tumour.
• Medulloepithelioma.
• Ependymoblastoma.
• Large cell médulloblastoma.
• Metastatic medulloblastoma (on CNS MRI and/or positive cytospin of postoperativelumbar CSF).
• Patient previously treated for a brain tumour or any type of malignant disease.
• Patients who are pregnant.
• Females who are sexually active and not taking reliable contraception.
• Known predisposition to medulloblastoma e.g. Gorlin's syndrome.