How well a patient responds to treatment is affected by their age at the time of diagnosis; the size and extent of the tumor; the amount of mass that can be removed safely; and the level of metastatic disease (the M stage). Overall, the Central Brain Tumor Registry of the United States reports about 65% – 70% of adults (age 20+) with medulloblastoma are alive at 5 years following diagnosis. It is important to realize these statistics do not reflect differences in outcome between low risk and high risks groups (since high risk groups may not do … Selanjutnya
Tumors recur when all the tumor cells cannot be removed by surgery or killed by other treatments. In children, medulloblastoma tends to “seed” or drop tumor cells into the spinal fluid. These cells can give rise to tumor growth in the spine. This type
of spread may or may not be accompanied by tumor regrowth in the cerebellum. In adults, the tumor tends to first regrow in the cerebellum. On very rare occasions, the tumor may spread elsewhere in, and outside, of the central nervous system.
Recurring medulloblastoma is treated aggressively with repeated surgery, re-irradiation if possible, … Selanjutnya
MRI scanning of the brain will be done every 2-3 months and spinal MRI every 4-6 months for the first two years following surgery. The scans help determine the effectiveness of treatment, and are used to monitor for early evidence of a recurrence. Scans will be done less frequently thereafter, unless specific symptoms develop that might indicate further growth. Your doctor will determine the appropriate schedule.
Children should be carefully evaluated for long-term cognitive problems, and should
receive early aggressive learning support. Neuropsychological testing before treatment can serve as a baseline for follow up evaluations. If learning … Selanjutnya
Despite its impact on increasing survival, the tumor and its treatment can cause significant side effects. Your healthcare team can speak with you about the potential side effects of your/your child’s personalized treatment plan, and help you weigh risks against the benefits. Some of the more common effects are discussed here. In a recent study, about 25% of children undergoing surgery for their tumor developed delayed onset (usually 6 to 24 hours after awakening) loss of speech which was often associated with decreased muscle tone, unsteadiness, emotional lability, and irritability. This syndrome, called “posterior fossa mutism … Selanjutnya
Chemotherapy uses powerful drugs to kill cancer cells. For children with medulloblastoma, chemotherapy is used to reduce the risk of tumor cells spreading through the spinal fluid. For adults, this benefit is not quite as clear since their tumors tend to regrow in the cerebellum. Because different drugs are effective during different phases of a cell’s life cycle, a combination of drug may be given. The combination increases the likelihood of more tumor cells being destroyed.
Chemotherapy is now a standard part of treatment for children with medulloblastoma. Most children are treated in clinical trials — organized … Selanjutnya