Treatment of High-Risk Cerebral Primitive Neuroectodermal Tumors in Children Aged Over 5 Years

Inclusion Criteria:

1. Type of tumor:

   * Metastatic medulloblastoma whatever the quality of the initial resection (radiologically visible metastases by MRI and/or CSF invaded by at least one mass of tumoral cells).
   * Incompletely resected local medulloblastoma with a residue \> 1.5 cm2.
   * Anaplastic, large cell medulloblastoma whatever the risk criteria (localized or metastatic, complete or incomplete resection).
   * Medulloblastoma with amplification of c-myc or N-myc whatever the risk criteria (local or metastatic, complete or incomplete resection).
   * Local and/or metastatic sustentorial PNET.
2. Age at diagnosis of the medulloblastoma of more than 5 years and less than 20 years.
3. Age at diagnosis of S-PNET of more than 10 years and less than 20 years.
4. Nutritional and general status compatible with treatment, Lansky score \> 60.
5. Estimated life expectancy \> 1 months.
6. Radiographs must be available for the second reading in dicom format on a CD-ROM.
7. Hematological function at diagnosis: PMN \> 1.0 x 109/l and platelets \> 100 x 109/l.
8. Hepatic function at diagnosis: serum bilirubin \< 1.5 times normal value; ASAT and ALAT \< 2.5 times normal values; prothrombin time \> 50%; fibrinogen \> 1.5 g/l.
9. Renal function at diagnosis: serum creatinine according to age in a correctly hydrated child: 1 to 15 years \< 65 micromol/l; 15 to 18 years \< 110 micromol/l.
10. No organ toxicity (Grade \> 2 according to NCI-CTC coding, version 2.0)
11. No other concomitant anti-cancer treatment.
12. No prior anti-cancer therapy.
13. No prior irradiation.
14. Written informed consent signed by both parents or legal guardians

Exclusion Criteria:

1. Failure to comply with one of the inclusion criteria.
2. Severe or life-threatening infection.
3. Uncontrolled active or symptomatic intracranial hypertension.
4. Refusal of parents or legal guardian.
5. Patients incapable of undergoing medical follow-up for geographical, social or mental reasons