Skip to Main Content

Medulloblastoma Treatment

Medulloblastoma is an aggressive brain tumor. It is one of the most common cancerous brain tumors in childhood. Medulloblastoma accounts for about 20% of all childhood malignant brain tumors. The tumor can spread to other parts of the central nervous system (brain and the spinal cord).

The brain tumor program at St. Jude Children’s Research Hospital specializes in treatments for medulloblastoma. We are a world leader in the management of this disease.

Find out more about medulloblastoma on the Together by St. Jude online resource.

Medulloblastoma types

Studies from St. Jude and other institutions have found that medulloblastoma can be divided into molecular groups and subgroups. This is important because knowing the grouping allows us to determine the best treatment for your child.

So, molecular testing must be done to get the correct diagnosis and determine the best treatment.

Molecular groups

The molecular groups of medulloblastoma are:

  • Medulloblastoma, WNT activated
  • Medulloblastoma, Sonic Hedgehog (SHH) activated
  • Medulloblastoma, non-WNT/non-SHH
    • Medulloblastoma group 3
    • Medulloblastoma, group 4

Histologic groups

You may also find in pathology reports that medulloblastoma is described histologically (by how the tumor looks under the microscope). While this grouping may be helpful, it is incomplete without molecular testing.

The following are the histologic groups and how they associate with the molecular groups:

  • Medulloblastoma classic: Medulloblastomas with classic histology mostly belong to WNT and group 4 categories, but some group 3 and SHH tumors may have classic histology.
  • Medulloblastoma large cell anaplastic: Medulloblastomas with large cell or anaplastic histology mostly belong to the group 3 and SHH activated tumors.
  • Medulloblastoma desmoplastic nodular: Medulloblastomas with true desmoplastic nodular histology are almost always SHH activated.
  • Medulloblastoma with extensive nodularity: Medulloblastomas with true extensive nodularity histology are almost always SHH activated.

Recently, these types have been further divided into the following subgroups:

  • Medulloblastoma, WNT activated
    • (no subgroups)
  • Medulloblastoma, SHH activated
    • SHH-1
    • SHH-2
    • SHH-3
    • SHH-4
  • Medulloblastoma, non-WNT/non-SHH
    • G3/G4- I
    • G3/G4-II
    • G3/G4-III
    • G3/G4-IV
    • G3/G4-V
    • G3/G4-VI
    • G3/G4-VII
    • G3/G4-VIII

Treatment of medulloblastoma

Treatment of medulloblastoma includes surgery, chemotherapy, and in most cases radiation therapy.

  • Surgery removes part or all of the tumor tissue. This takes out cancerous tissue and helps determine the type of tumor.
  • Chemotherapy (chemo) is important in the treatment of these tumors. The exact type of chemotherapy and the length of treatment will depend on your child’s age and type of tumor.
  • Radiation: The dose, location, and timing of radiation will depend on many factors. These include your child’s age, type of tumor, and if it has spread to other parts of the brain or spine.

At St. Jude, the treatment of medulloblastoma differs by the:

  • Molecular group and subgroup
  • Extent of its spread at the time of diagnosis (metastatic state)
  • Age at diagnosis

Our goal is to give each child the most effective therapy to cure their tumor while sparing them unnecessary treatment to improve their long-term quality of life. As a result, our treatments use less chemotherapy and radiation therapy than most other treatment centers. We also use the latest technology, such as advanced molecular testing and proton therapy.

Infants and young children

Infants with medulloblastoma are a special group. They are defined as any child who is younger than 3 years old when diagnosed.

Most medulloblastomas in this age group belong to 2 molecular groups: SHH-activated (75%) and group 3 (20%), with the remaining 5% being group 4.

Because the brains of infants are still developing, radiation to the brain may cause long-term problems with thinking and learning skills. Our strategy is to avoid or minimize radiation in these children when possible. So, infants with SHH-activated medulloblastoma (SHH-1 and SHH-2) do not receive radiation to the brain.

The remaining 25%, who have group 3 (G3) and group 4 (G4) medulloblastoma, have a more aggressive disease. We have found this disease to be incurable without radiation.

Children with G3 or G4 get a radiation-delaying strategy. It uses chemotherapy to reduce and control the disease until they are older than 3 years. These patients are reassessed at age 3 for proton-beam treatment to their brain and spine. Children with minimal to no visible disease get reduced doses of radiation. In this way, we give as little radiation as possible to children who need it.

Children older than 36 months (3 years)

Most medulloblastomas are diagnosed in children older than 3 into adulthood. Like the infants, these patients are treated at St. Jude based on their molecular group and how far the disease has spread.

All patients receive surgery, radiation to the brain and spine, and chemotherapy. But the doses of radiation and the number of chemotherapy courses depend on the molecular group of medulloblastoma.

St. Jude is a leader in the treatment of certain molecular groups, such as WNT-activated medulloblastoma. We reduce the dose of therapy to these tumors because they have a better prognosis and are more likely to be cured without a lot of side effects.

For other more aggressive molecular groups, such as group 3, we also lead the way in adding new therapies to help improve prognosis.

All medulloblastoma patients get supportive care that includes physical therapy, speech therapy, occupational therapy, and neurocognitive therapy. Our goal is to maximize their recovery and minimize the side effects of therapy.

Medulloblastoma clinical trials

St. Jude clinical trials were the first to introduce treatment of medulloblastoma by the tumor’s molecular type. This continues today.

We offer clinical trials and research studies for children, teens, and young adults with medulloblastoma. Learn more about clinical research at St. Jude.

SJiMB21: Risk-Based Medulloblastoma Treatment for Infants and Young Children

Study goal:

This study uses a risk-directed approach to find out which types of treatment will work best and have the fewest side effects for infants and children with medulloblastoma.


Birth to 5 years old

PBTC49: Phase 1 Trial of Savolitinib in Recurrent, Progressive or Refractory Medulloblastoma, High-Grade Glioma, or Diffuse Intrinsic Pontine Glioma

Study goal:

 To see if savolitinib is safe and tolerable in children with brain tumors


Between 5 years old and 21 years old

Medulloblastoma care at St. Jude

St. Jude provides the highest quality of care for patients with medulloblastoma:

  • We bring together medical experts and specially trained staff to care for your child. We also work with brain surgeons (neurosurgeons) at Le Bonheur Children’s Hospital.
  • Our Brain Tumor program has expert doctors in molecular neuropathology. They look at tumors under the microscope and do molecular tests. This allows us to tailor your child’s treatment to the tumor’s molecular class and subclass.
  • We have a special team that helps understand the makeup of the tumor. This team includes doctors and scientists who study:
    • Cancer cells
    • How the cancer happened
    • Current medicines and treatments to kill cancer cells
    • What makes cancer cells grow and what new medicines can stop them
    • New medicines and other therapies to improve how treatments work
  • Our brain tumor clinical trials in medulloblastoma have led to lower-intensity treatments based on molecular class of medulloblastoma.
  • Hospitals around the world (United States, Canada, Australia, and New Zealand) have opened and continue to open our clinical trials so they can bring St. Jude treatment programs to their patients.
  • The St. Jude Proton Therapy Center is the first center in the world just for children.
  • We also treat patients on studies developed by the Children’s Oncology Group, the Pediatric Brain Tumor Consortium, and the Pacific Pediatric Neuro-Oncology Consortium. Many St. Jude staff members play key roles in developing these studies. They are large trials carried out at multiple centers across the United States.
  • St. Jude offers a dedicated team of specialists to meet the needs of children with brain tumors, including:

More reasons to choose St. Jude for care include:

  • We are consistently ranked among the best childhood cancer centers in the nation by US News & World Report.
  • At St. Jude, we have created an environment where children can be children and families can be together.
  • We lead more clinical trials for childhood cancer than any other hospital in the U.S. 
  • St. Jude is the only National Cancer Institute–designated Comprehensive Cancer Center just for children. A Comprehensive Cancer Center meets rigorous standards for research that develops new and better approaches to prevent, diagnose, and treat cancer.
  • The nurse-to-patient ratio at St. Jude is about 1:3 in hematology and oncology and 1:1 in the Intensive Care Unit.
  • Patients may be able to get expert, compassionate care and treatment closer to their homes through our St. Jude Affiliate clinics.

Get more information about the Brain Tumor Treatment program at St. Jude.

A statue of children running and holding hands

Seeking treatment at St. Jude

Patients accepted to St. Jude must have a disease we treat and must be referred by a physician or other qualified medical professional. We accept most patients based on their ability to enroll in an open clinical trial.

How to seek treatment

Contact us

How to get brain tumor treatment at St. Jude

You can start the referral process by letting your physician know you would like a second opinion from St. Jude. They can contact our 24-hour beeper service or contact our brain tumor coordinator. You may also contact the brain tumor coordinator directly with questions.

Learn more about the types of brain tumors we treat at St. Jude and our brain tumor eligibility requirements.

Physician / Patient Referral Office

Call: 1-888-226-4343 (toll-free) or 901-595-4055 (local)  | Email:
Fax: 901-595-4011 | 24-hour pager: 1-800-349-4334

Contact the Brain Tumor Team directly:

Submit brain tumor contact form

Contact the Surgery Team directly:


Learn more