Treatment results of juvenile XXXX .

@entity1 @entity816 @entity5
Treatment results for 36 @entity1 with juvenile @entity816 treated from 1942 through 1985 at the University of California, San Francisco, were reviewed. Twenty-two @entity5 were located in the posterior fossa, 10 were in the hypothalamic region, and four were in the cerebral hemispheres. Twenty-eight @entity1 were less than 18 years of age. The overall survival rate was 83% and 70% at 10 and 20 years, respectively. All 12 @entity1 who had total @entity5 resection remain disease-free; only two of the 12 received postoperative irradiation. The 10- and 20-year freedom-from-progression for the 19 @entity1 who had incomplete resection and received at least 40 Gy of postoperative irradiation was 74% and 41%, respectively. All @entity1 who failed treatment had local recurrence. One @entity1 developed diffuse meningeal seeding, after four local recurrences in the posterior fossa over a 23-year period. Six @entity1 failed treatment and had a repeat biopsy at the time of recurrence or at postmortem examination, and three showed histological progression of the @entity5 to an @entity816 . Based on this study and others in the literature, a protocol has been adopted whereby @entity1 who have total @entity5 resection are not treated with postoperative irradiation. @entity1 who have incomplete @entity5 resection and are older than 3 years of age are currently treated with postoperative partial-brain irradiation, to a dose of 45 to 60 Gy. In general, young @entity1 with incomplete resection are followed closely with computerized tomography or magnetic resonance imaging and are treated with chemotherapy or irradiation if @entity5 progression is documented.
