To explore the impact of risk grading and stratified treatment of children with medulloblastoma (MDB) on the prognosis.

A retrospective analysis of the clinical data of 32 children with MDB treated by microsurgery through the cerebellar medulla oblongata approach admitted by the author from January 2011 to December 2019 was retrospectively analyzed. According to risk stratification criteria, MDB was divided into low-risk, intermediate-risk and high-risk groups, and the relationship between treatment mode, risk classification and prognosis was analyzed.

There were 29 cases of total resection and near total resection, and the rate of total resection and near total resection was 90.6%; 3 cases were subtotal resection. There were no deaths related to surgery and no permanent cerebrospinal fluid leakage. The follow-up time was 6-84 months, the 3-year overall survival (OS) rate was 96.9%, and the 5-year OS rate was 84.4%. The 3-year and 5-year OS rate of the low-risk group was significantly better than that of the high-risk group. The 5-year OS rate of the intermediate-risk group was 91.7%, and the 5-year OS rate of the high-risk group was only 63.6%. The combined 5-year OS rate of combined chemotherapy (ChT) and radiotherapy RT after surgery was 95.5%, and surgery alone had the worst effect, with a 3-year OS rate of only 66.7%.

According to the risk classification of MDB, an individualized treatment plan is helpful to increase the survival rate of MDB treatment and improve the quality of life. Combining RT and ChT after surgery is of great significance to improve the prognosis.