Medulloblastoma is one of the most malignant tumors of the nervous system. It is not only highly malignant but also easily disseminated, and even extracranial metastases have been reported. Interstitial ventricular meningioma is prone to local recurrence and metastasis via cerebrospinal fluid, and is also difficult to treat. With the development of modern microscopic neurosurgery, intraoperative microscopic total resection is now possible in most children. In combination with postoperative radiotherapy, a significant proportion of children with medulloblastoma and ventricular meningioma can survive tumor-free for a long time. The following is an example of the comprehensive treatment of malignant brain tumors in children, using medulloblastoma as an example. Starting in the late 1970s, the standard of care for children older than 3 years of age with standard-risk medulloblastoma was surgery followed by radiation therapy in January. In this treatment, the 5-year disease-free survival rate was 60%, but it was inevitably accompanied by sequelae of whole-cranial and whole-spinal cord radiotherapy. Beginning in the 1980s, 2 large multicenter randomized clinical trials sought to reduce the amount of total cranial and total spinal cord radiation therapy. The North American group found a significant increase in spinal recurrence if the amount of spinal cord radiation therapy was reduced to 23.4 Gy. However, long-term disease-free survival was similar for the 35Gy or 23.4Gy all-cranial all-spinal prophylaxis groups. The European study group also noted that there was an increased risk of recurrence if the amount of total cranial and total spinal cord prophylaxis was reduced. Also, if chemotherapy is given before 25Gy of total cranial and spinal cord prophylactic radiotherapy immediately after surgery, the prognosis of patients is not good. On the contrary, the prognosis was good when 25Gy of whole cranial and whole spinal cord prophylactic radiotherapy was administered immediately after surgery without chemotherapy. In addition, many patients in this group were not staged well, which contributes to the fragility of this finding. In a group of studies without randomization subtractive radiotherapy combined with extended chemotherapy Packeretal. showed encouraging results, however once subtractive radiotherapy is administered, the quality of radiotherapy becomes prognostic: whole cranial whole spinal cord prophylactic radiotherapy must encompass all risk areas. New radiotherapy techniques such as hyperfractionated radiotherapy; additive radiotherapy with reduced tumor primary foci or treatment with protons are now available. Hyperfractionated radiotherapy has shown encouraging results in reducing side effects and survival rates. Adjuvant chemotherapy has only recently shown its benefits. A European randomized controlled study group showed a 5-year disease-free survival rate: radiotherapy combined with chemotherapy versus radiotherapy alone, 75%:60%. Similarly, the current trend in the treatment of labeled-risk medulloblastoma is a reduced dose of about 25 Gy of whole-cranial, whole-spinal cord radiation combined with chemotherapy, with the tumor bed remaining at 54 Gy. Once metastases have developed, multicenter studies have shown a benefit of adjuvant chemotherapy. The use of lomustinel or vincristine during and after radiotherapy increased recurrence-free survival compared with radiotherapy alone. Despite recent advances in chemotherapy, 5-year survival rates in this setting are in the range of 30%-50%. To improve the prognosis of metastatic medulloblastoma, another suggestion is to use high intensity chemotherapy (auto-stem cell transplantation) without increasing the dose of radiotherapy. Recent reports have shown to improve tumor control rates. The optimal timing of treatment with these different approaches still varies. There are theoretical benefits of a useful sandwich treatment approach. That is, between surgery and radiotherapy: since surgery disrupts part of the blood-brain barrier it allows better access to the tumor bed and also allows early killing of micro-metastases and reduces hematologic toxicity when applied before total cranial and spinal radiotherapy. However, in some controlled studies, it was found that especially in children with metastases, if adjuvant chemotherapy is given after radiotherapy, the delay in initiation of radiotherapy can be avoided (later initiation of radiotherapy is likely to reduce survival). In some young children, it is necessary to find the most appropriate treatment in order to reduce some unacceptable side effects. In the nineties, a large multicenter study group showed that conventional chemotherapy could avoid tumor growth and delay the start of total cranial and spinal radiotherapy by 1-2 years, especially in limited stage tumors. Conversely, if the tumor is fully resected and there are no metastases, postoperative treatment may be adjuvant chemotherapy only. Radiotherapy may be used only for the appearance of tumor growth or recurrence, which does not reduce the 5-year survival rate. North American and French groups have shown that extended conventional chemotherapy can avoid total cranial and spinal cord radiotherapy in most children, with a 5-year survival rate of 70%. Studies have shown that 30% of children can be cured with postoperative chemotherapy alone with less toxicity. The majority of recurrences are localized and may be treated with conventional chemotherapy, high intensity chemotherapy (auto-stem cell transplantation), reoperation if possible, and radiotherapy limited to the posterior cranial fossa. The German group started with an aggressive treatment, intravenous and intracerebrospinal fluid MTX, which inevitably has neurotoxicity, but with a 5-year disease-free survival rate of 83%. With these two groups, the neurotoxicity is much greater when young children are treated with full cranial and full spinal cord radiation. The prognosis for medulloblastoma in young children with metastases remains poor and has not been shown to be an effective treatment and has more severe side effects. The current study group shows that sequential, intense chemotherapy has the potential to improve the prognosis. If the tumor is large and difficult to remove surgically, postoperative chemotherapy is discussed according to the type of pathology. In fact, chemotherapy can improve the efficacy of surgery and reduce postoperative sequelae (ambulation and mutism) while eliminating the tumor and avoiding delay in tumor treatment due to surgical sequelae. The age of avoidance of total cranial and total spinal cord radiotherapy for medulloblastoma of standard risk type should still be discussed. 3 years or older, radiotherapy should be delayed. A new protocol for mesenchymal ventricular meningioma appeared in the December 2011 issue of The Lancet. Of course we are aware of the findings of some scientists who believe that the most effective treatment for ventricular duct meningioma is surgery and that radiotherapy is extremely limited in its help. In addition, the current staging of tumors has emerged due to advances in subfraction biology with new prognostic factors potentially influencing the treatment strategy. Developments in surgery, radiotherapy and chemotherapy have enabled medulloblastoma to be well diagnosed and treated, and follow-up of the tumor should be continued after treatment is completed. Long-term side effects should be taken into account in order to establish a multidisciplinary follow-up, as well as sports specialists, educational specialists, and assistance during the different periods of the child’s life. The first priority of new treatments is to assess and prevent these side effects. The availability of multicenter, preferably international, clinical biological research groups has led to an increasing number of targeted treatments.