Medulloblastoma medical therapy: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
==Medical Therapy== | ==Medical Therapy== | ||
* The algorithm below summarize the management approach for medulloblastoma patients:<ref name="pmid22622599">{{cite journal| author=von Hoff K, Rutkowski S| title=Medulloblastoma. | journal=Curr Treat Options Neurol | year= 2012 | volume= 14 | issue= 4 | pages= 416-26 | pmid=22622599 | doi=10.1007/s11940-012-0183-8 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22622599 }} </ref><ref> Clinical Practice Guidelines in Oncology Central Nervous System Cancers. National Comprehensive Cancer Network.(2015) http://www.lecba-rakoviny.cz/dokumenty/NCCN_Guidelines_cns_2011.pdf Accessed on September,25 2015</ref> | * The algorithm below summarize the management approach for medulloblastoma patients:<ref name="pmid22622599">{{cite journal| author=von Hoff K, Rutkowski S| title=Medulloblastoma. | journal=Curr Treat Options Neurol | year= 2012 | volume= 14 | issue= 4 | pages= 416-26 | pmid=22622599 | doi=10.1007/s11940-012-0183-8 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22622599 }} </ref><ref name="N"> Clinical Practice Guidelines in Oncology Central Nervous System Cancers. National Comprehensive Cancer Network.(2015) http://www.lecba-rakoviny.cz/dokumenty/NCCN_Guidelines_cns_2011.pdf Accessed on September,25 2015</ref> | ||
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===Chemotherapy=== | ===Chemotherapy=== | ||
* Adjunctive chemotherapy are required for the management of medulloblastoma patients.<ref name="pmid22622599">{{cite journal| author=von Hoff K, Rutkowski S| title=Medulloblastoma. | journal=Curr Treat Options Neurol | year= 2012 | volume= 14 | issue= 4 | pages= 416-26 | pmid=22622599 | doi=10.1007/s11940-012-0183-8 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22622599 }} | * Adjunctive chemotherapy are required for the management of medulloblastoma patients.<ref name="pmid22622599">{{cite journal| author=von Hoff K, Rutkowski S| title=Medulloblastoma. | journal=Curr Treat Options Neurol | year= 2012 | volume= 14 | issue= 4 | pages= 416-26 | pmid=22622599 | doi=10.1007/s11940-012-0183-8 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22622599 }} </ref> | ||
* | * Chemotherapeutic agents used for management of standard risk medulloblastoma patients include: | ||
:* [[Lomustine]] | |||
* | :* [[Vincristine]] | ||
:* [[Cisplatin]] | |||
:* [[ | * Chemotherapeutic agents used for management of high risk medulloblastoma patients include: | ||
:* [[ | :* [[Carboplatin]] | ||
:* [[ | :* [[Cyclophosphamide]] | ||
:* [[Vincristine]] | |||
:* [[Cisplatin]] | |||
==References== | ==References== | ||
Revision as of 19:35, 2 October 2015
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Medulloblastoma Microchapters |
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Diagnosis |
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Treatment |
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Case studies |
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Medulloblastoma medical therapy On the Web |
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American Roentgen Ray Society Images of Medulloblastoma medical therapy |
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Risk calculators and risk factors for Medulloblastoma medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Haytham Allaham, M.D. [2]
Overview
Medical Therapy
Optimal surgical excision | |||||||||||||||||||||||||||||
Histopathological analysis and detailed staging | |||||||||||||||||||||||||||||
Risk stratification | |||||||||||||||||||||||||||||
Radiotherapy and chemotherapy
administered according to the risk stratification criteria | |||||||||||||||||||||||||||||
Standard risk patients Craniospinal radiation OR Concurrent chemoradiotherapy followed by chemotherapeutic regimens | High risk patients Craniospinal radiation followed by chemotherapeutic regimens | ||||||||||||||||||||||||||||
Risk Stratification Criteria
- The risk stratification criteria may help predict the protocol that should be used for the treatment of medulloblastoma patients.[3][4]
- The table below demonstrates the risk stratification criteria for medulloblastoma patients:
| Parameters | Standard Risk Group | High Risk Group |
|---|---|---|
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Age |
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Extent of previous surgical resection |
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Tumor stage |
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Radiation Therapy
- Radiotherapy is the mainstay of treatment for medulloblastoma.[3]
- Radiotherapy for medulloblastoma must be started within 6 weeks following surgery.
- The main radiotherapy techniques used in the management of medulloblastoma patients include:
- Conventional radiotherapy technique
- Intensity modulated radiotherapy technique
- Three dimensional radiotherapy technique
- Three dimensional radiotherapy technique demonstrated better outcomes when compared to conventional and intensity modulated radiotherapy techniques.
- The radiotherapy dose is adjusted according to the risk stratification of medulloblastoma patients.
- As medulloblastoma tends to spread along the cerebrospinal fluid, it is recommended to deliver a craniospinal irradiation with a boost to the posterior fossa.
- Side effects of radiotherapy may include:
- Altered cognitive level
- Deafness
- Endocrinopathies
Chemotherapy
- Adjunctive chemotherapy are required for the management of medulloblastoma patients.[1]
- Chemotherapeutic agents used for management of standard risk medulloblastoma patients include:
- Chemotherapeutic agents used for management of high risk medulloblastoma patients include:
References
- ↑ 1.0 1.1 von Hoff K, Rutkowski S (2012). "Medulloblastoma". Curr Treat Options Neurol. 14 (4): 416–26. doi:10.1007/s11940-012-0183-8. PMID 22622599.
- ↑ Clinical Practice Guidelines in Oncology Central Nervous System Cancers. National Comprehensive Cancer Network.(2015) http://www.lecba-rakoviny.cz/dokumenty/NCCN_Guidelines_cns_2011.pdf Accessed on September,25 2015
- ↑ 3.0 3.1 Bartlett F, Kortmann R, Saran F (2013). "Medulloblastoma". Clin Oncol (R Coll Radiol). 25 (1): 36–45. doi:10.1016/j.clon.2012.09.008. PMID 23245832.
- ↑ Medulloblastoma staging. Wikibooks(2015) https://en.wikibooks.org/wiki/Radiation_Oncology/Medulloblastoma/Staging Accessed on September, 28th 2015)