Treatment of Brain Tumors

To the Editor: In the report by Rutkowski et al. (March 10 issue) 1 regarding treatment of early childhood medulloblastoma with postoperative chemotherapy alone, 20 of 43 children under the age of three years (46.5 percent) had desmoplastic medulloblastoma, and these 20 children had a five-year progression-free survival rate of 85 percent. The desmoplastic variant is considered to be less aggressive than classic medulloblastoma and occurs mainly in adolescents and adults. 2 , 3 As far as we know, desmoplastic histologic features are not found in a large proportion of children who are younger than three years of age. Could the somewhat higher-than-expected . . .