Medulloblastoma medical therapy
|
Medulloblastoma Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case studies |
|
Medulloblastoma medical therapy On the Web |
|
American Roentgen Ray Society Images of Medulloblastoma medical therapy |
|
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
The risk stratification criteria predicts the protocol used for the management of medulloblastoma patients. Radiotherapy is the mainstay of treatment for medulloblastoma. Radiotherapy for medulloblastoma must be started within the 6 weeks period following surgery. Adjunctive chemotherapy is also required for the management of certain medulloblastoma patients.[1][2]
Medical Therapy
Optimal surgical excision | |||||||||||||||||||||||||||||
Histopathological analysis and detailed staging | |||||||||||||||||||||||||||||
Radiotherapy and chemotherapy
administered according to the risk stratification criteria | |||||||||||||||||||||||||||||
| Standard risk patients | High risk patients | ||||||||||||||||||||||||||||
Craniospinal radiation OR Concurrent chemoradiotherapy followed by chemotherapeutic regimens |
Craniospinal radiation followed by chemotherapeutic regimens | ||||||||||||||||||||||||||||
Risk Stratification Criteria
- The risk stratification criteria predicts the protocol used for the management of medulloblastoma patients.[3][4]
- The table below demonstrates the risk stratification criteria for medulloblastoma patients:
| Parameters | Standard Risk Group | High Risk Group |
|---|---|---|
|
Age |
|
|
|
Extent of previous surgical resection |
|
|
|
Tumor stage |
|
Radiation Therapy
- Radiotherapy is the mainstay of treatment for medulloblastoma.[3]
- Radiotherapy for medulloblastoma must be started within the 6 weeks period 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 is required for the management of medulloblastoma patients.[1][2]
- Recommended chemotherapeutic regimens used for the management of standard risk medulloblastoma patients include a combination of lomustine AND vincristine AND cisplatin
- Recommended chemotherapeutic regimens used for the management of high risk medulloblastoma patients include is cyclophosphamide AND vincristine AND cisplatin
- Other chemotheuraptic agents used for the management of medulloblastoma iclude:
References
- ↑ 1.0 1.1 1.2 von Hoff K, Rutkowski S (2012). "Medulloblastoma". Curr Treat Options Neurol. 14 (4): 416–26. doi:10.1007/s11940-012-0183-8. PMID 22622599.
- ↑ 2.0 2.1 2.2 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)