Comprehensive management of medulloblastoma based on revised molecular risk stratification

Abstract

Medulloblastoma is the most common malignant central nervous system tumor in children. The current treatment approach primarily consists of surgery combined with adjuvant radiotherapy and chemotherapy. Postoperative precision treatment plans based on risk stratification effectively prevent overtreatment in low⁃risk patients while addressing the therapeutic needs of high⁃risk groups. Traditional clinical risk stratification primarily considers factors such as age, clinical stage, and extent of surgical resection. In recent years, advances in understanding the key molecular markers of medulloblastoma have led to the integration of molecular subtypes and molecular and genetic characteristics into the risk stratification framework. It has resulted in the development of a revised molecular risk stratification system, which makes it possible to distinguish children in different risk groups more efficiently and guides subsequent precision treatment. This paper intends to summarize the pathological characteristics of medulloblastoma, risk stratification based on clinical features and the revised molecular risk stratification which integrates clinical and molecular genetic characteristics, so as to provide a guideline for the formulation of subsequent comprehensive diagnosis and treatment plans.

DOI: 10.3969/j.issn.1672⁃6731.2024.10.003