| Treatment for Medulloblastoma in India is doneat | | | | randomly received either the standard 36 Gy or a |
| best neurosurgical institute. Indian medical tourism | | | | reduced dose of 24 Gy to the neuraxis. It was found |
| offers our clients the excellent range of medical | | | | that no statistical difference in progression-free |
| treatments, with extremely competent, highly | | | | survival rates was demonstrated between the |
| respected Indian medical specialists. India boasts of | | | | groups as long as the initiation of radiotherapy was |
| several good private owned hospitals in Mumbai, Delhi, | | | | not delayed by the administration of chemotherapy |
| Hyderabad and Chennai with facilities second to none. | | | | before radiation. |
| They have some of the best specialist doctors, with | | | | Chemotherapy |
| most top end being educated in USA and UK. People | | | | - Average-risk disease |
| prefer treatment for Medulloblastoma in India | | | | - The most encouraging results with adjuvant |
| because it is available at various hospitals where the | | | | chemotherapy have been reported in children with |
| surgeon and there team are dedicated to bring smile | | | | nondisseminated medulloblastoma receiving 8 cycles |
| on there patience face. | | | | of lomustine (CCNU), vincristine and cisplatin |
| What is Medulloblastoma? | | | | chemotherapy for approximately 1 year following |
| Medulloblastoma is a malignant, invasive embryonal | | | | conventional dose radiotherapy and concomitant |
| tumor of the cerebellum which occurs more often in | | | | vincristine. |
| children. It has a predominantly neuronal | | | | Surgical Care |
| differentiation and a tendency to metastasize via | | | | - Suboccipital craniotomy |
| CSF pathways. Histologically, classic Medulloblastomas | | | | - Because the tumor is often friable, gentle suction is |
| are composed of densely packed cells with | | | | used. Microdissection is used to remove adherent |
| round-to-oval or carrot-shaped highly hyperchromatic | | | | portions. |
| nuclei surrounded by scanty cytoplasm. Neuroblastic | | | | - Modern neurosurgical techniques permit complete or |
| rosettes are a typical but not constant feature. | | | | near-complete resection with little or no significant |
| There are four histologic types: Desmoplastic | | | | increase in morbidity and mortality rates compared |
| Medulloblastoma, Large Cell Medulloblastoma, | | | | with more conservative surgery. |
| Medullomyoblastoma, Melanotic Medulloblastoma. | | | | - Because surgical estimates of the extent of |
| Symptoms of Medulloblastoma | | | | resection may not be reliable, postoperative MRI |
| The list of signs and symptoms mentioned in various | | | | evaluation for residual disease is required within |
| sources for Medulloblastoma includes the symptoms | | | | several days of the procedure. |
| listed below: | | | | - As many as 40% of patients have some degree of |
| - Increased intracranial pressure | | | | new neurologic dysfunction postoperatively. One |
| - Brain tumor | | | | ill-defined syndrome is posterior fossa syndrome, |
| - Brain swelling | | | | characterized by mutism, cerebellar dysfunction, |
| - Obstruction of cerebrospinal fluid flow | | | | supranuclear cranial nerve palsy and hemiparesis that |
| - Enlarged head | | | | occur 12-48 hours after surgery. As many as 50% |
| - Vomiting | | | | of patients have residual deficits. |
| - Nausea | | | | Ventriculoperitoneal shunt: Approximately 50% of |
| - Irritability | | | | patients require placement of a ventriculoperitoneal |
| - Lethargy | | | | shunt at the time of operation (or shortly thereafter) |
| - Personality changes | | | | because of unresolving obstructive hydrocephaly. |
| - Attention deficit | | | | Third ventriculostomy is increasingly used to avoid |
| - Loss of motor skills | | | | the placement of a permanent ventricular shunt. |
| - Impaired walking ability | | | | Follow up care for Medulloblastoma |
| - Impaired speech | | | | Inpatient & Outpatient Medications for |
| - Impaired ability to control voluntary movements | | | | Medulloblastoma |
| - Ataxic gait | | | | - Inpatient medications are dictated by the most |
| - Muscle weakness | | | | current chemotherapeutic protocols available for the |
| Treatment options for Medulloblstoma | | | | treatment of medulloblastoma. The most commonly |
| Standard therapy for Medulloblastoma consists of | | | | used chemotherapeutic agents are DNA alkylators. |
| aggressive surgery followed by radiation to the entire | | | | - Most regimens require the concomitant use of an |
| craniospinal axis with boost to both the primary | | | | antiemetic. |
| tumor site and focal CNS metastatic sites. Recently, | | | | - Because of the immunosuppressive effects of |
| adjuvant chemotherapy has also been shown to be | | | | chemotherapy, trimethoprim sulfamethoxazole and |
| beneficial. | | | | nystatin are commonly prescribed for prophylaxis |
| - Radiation therapy | | | | against Pneumocystis carinii pneumonia and |
| - Average-risk disease | | | | mucocutaneous candidiasis, respectively, for the |
| - Reducing the amount of craniospinal radiation in an | | | | duration of treatment. |
| attempt to decrease morbidity without jeopardizing | | | | - Granulocyte colony stimulating factor (GCSF) |
| survival appears to be successful in this group. In a | | | | following chemotherapy may be used in treatment |
| report by the International Society of Pediatric | | | | regimens expected to cause marked neutropenia. |
| Oncology, children with average-risk medulloblastoma | | | | |