The Medulloblastoma Book ( Neuroscience Research Progress )

Publication series :Neuroscience Research Progress

Author: Dimitris Kombogiorgas (Consultant Neurosurgeon   Dr Sulaiman Al Habib Medical Group   Riyadh   Kingdom of Saudi Arabia)  

Publisher: Nova Science Publishers, Inc.‎

Publication year: 2014

E-ISBN: 9781631171918

P-ISBN(Hardback):  9781631171901

Subject: R73 Oncology

Keyword: Cell Biology

Language: ENG

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The Medulloblastoma Book

Chapter

Chapter 3: Genetics of Medulloblastoma

Abstract

Introduction

When Our Cerebellum is Developing Normally…

1. Embryonic Cerebellar Development: The Rhombic Lip and Cerebellar Radii

2. Postnatal Cerebellar Development: CGNP Proliferation and Migration

When Cerebellar Tumorigenesis Sets In…

1. Medulloblastoma Histopathology

2. Molecular Characterization of Medulloblastoma: Genetics, Cytogenetics and Epigenetics

Conclusion

References

Chapter 4: Imaging of Medulloblastoma

Department of Radiology, University of Texas Southwestern Medical Center and Children's Medical Center, Dallas, Texas, US

Abstract

Introduction

Imaging

Preoperative Imaging

Postoperative Imaging

Conclusion

References

Chapter 5: Surgical Treatment of Medulloblastoma

Abstract

Introduction

Preoperative Evaluation and Treatment Strategies

Hydrocephalus Management

Operative Positioning of Patient

Operation Technique

Intraoperative and Postoperative

Surgical Complications

Conclusion

References

Chapter 6: Radiotherapy in the Management of Medulloblastoma

Abstract

Introduction

General Principles of Pediatric Radiotherapy for Central Nervous System Tumors

Craniospinal Irradiation for Medulloblastoma

Role of Radiotherapy in Medulloblastoma

Radiotherapy Technique

Delivery of Treatment for Craniospinal Irradiation

Patient Preparation (Mould Room / Planning CT)

CT Protocol

Outline and Target Volume Definitions

Phase I: Craniospinal Irradiation

Phase II: Posterior Fossa / Tumor Bed Definition

Planning

Dose Prescriptions

New Technical Approaches

Proton Therapy

Pattern of Relapse in Medulloblastoma

Role of Radiotherapy in Recurrent Medulloblastoma

Conclusion

References

Chapter 7: Toxicity of Radiotherapy in the Treatment for Medulloblastoma

Abstract

Introduction

Radiobiology

Pathophysiology

Toxicity

Acute Effects

Acute Encephalopathy

Alopecia

Myelosuppresion

Mucositosis

Radiation Dermatitis

Nausea and Vomiting

Other Complications

Early Delayed Effects

Somnolence Syndrome

Focal Neurologic Symptoms

Myelopathy

Late Delayed Effects

Neurocognitive Effects

Cerebrovascular Effects

Ophthalmic Effects

Ototoxicity

Bone Hypoplasia

Endocrinopathies

Cardiac Toxicity

Pulmonary Toxicity

Reproductive Toxicity

Secondary Malignancies

Reducing Radiation Injury

Conclusion

References

Chapter 8: Chemotherapy of Medulloblastoma

Abstract

Introduction

Treatment Modalities

Surgery

Radiation

Chemotherapy

Treatment of Average-Risk Disease

Treatment of High-Risk Disease

Treatment of Infants with Medulloblastoma

Recurrent and Resistance Disease

Side Effects of Chemotherapy

Molecular Subtyping

Conclusion

References

Chapter 9: Metastatic Medulloblastoma: Clinical and Biological Insights

Abstract

Introduction

Diagnosis

Current Treatment Protocols

Genomics of Metastatic Medulloblastoma

Primary and Metastatic Compartments Are Genetically Distinct

Conclusion

References

Chapter 10: Intra-Cerebrospinal Fluid Therapy for Leptomeningeal Metastases in Medulloblastoma

Abstract

Introduction

Prevalence, Diagnosis and Staging of Leptomeningeal Disease

Leptomeningeal Metastases Directed Therapy

Blood-brain-Barrier and Blood-CSF-Barrier

CSF Flow Dynamics

LM Targeted Treatment Modalities in Medulloblastoma

Surgery

Cranio-spinal Radiotherapy

High Dose Chemotherapy

Intra-CSF administration of Chemotherapy

Criteria for Drug Selection of intra-CSF Administered Therapy

Neurotoxicity, Systemic Toxicity and Infectious Risk

Outcome of intra-CSF Administered Drugs

Modes of Delivery Intra-CSF administered Therapy

Site of Administration

Shunt versus No Shunt

Bolus versus Sustained Release

Future Directions

Improving Feasibility of Intra-CSF Drug Administration

Pharmacokinetic Optimisation of Drug Dosing

Developing New Drugs for Intrathecal Use

Conclusion

References

Chapter 11: Outcome and Long-Term Complications

Abstract

Introduction

Endocrine Sequelae

GH Deficiency (GHD)

Safety of Hormone Replacement in Children Treated for Brain Tumors

Molecular Basis of GH Oncogenic Potential

Oncologic Risk in Patients with Tumors

GH Therapy and Radiological Findings in Patients Treated for Brain Tumors

Gonadal Alterations

Hypothyroidism

Possible Morbidity Prevention

Hyperthyroidism

Thyroid Nodules

Hyperprolactinemia

Central Adrenal Insufficiency

Osteopenia/Osteoporosis

Overweight/Obesity, Dyslipidemia and Metabolic syndrome

Endocrine Sequelae after Radiotherapy Plus High Doses Chemotherapy

Brain Magnetic Resonance Imaging after High Dose Chemotherapy and Radiotherapy

Auditory Late Effects

Orthopedic Late Effects

Cardiac Toxicity

Pulmonary Toxicity

Second Tumors

Secondary Brain Tumors

Thyroid Tumors

Conclusion

References

Chapter 12: Medulloblastoma in Developmental Age: Long-Term Neurocognitive and Emotional-Behavioral Outcome

Abstract

Introduction

Neurocognitive Decline

The Roles of Surgery and Tumor Location

The Third Set Variables Concern Cognitive Reserve and Rehabilitation

Conclusion

References

Chapter 13: Neurocognitive Sequelae: Personal Experiences

Abstract

Introduction

Personal Experiences

Conclusion

References

Chapter 14: Medulloblastoma in Adulthood

Abstract

Introduction

Epidemiology and Clinical Presentation

Elderly patients

Radiation-induced adult MB

Tumor Location

Neuropathology

Survival

Quality of Life for Survivors

Prognostic Factors

Age

Gender

Residual disease

Histopathology

M stage

Adjuvant Treatments

Chemotherapy

Radiation therapy

Radiosurgery

Proton therapy

Recurrences

Extraneural Metastases

Molecular Features and Biology

Are Childhood and Adult MB Different?

Future

Conclusion

References

Chapter 15: Novel Therapies and Next Generation Clinical Trials in Medulloblastoma

Abstract

Introduction

The Genomic Landscape of Medulloblastoma

Advances in Medulloblastoma Clinical Trials

Standard-Risk Patients

High-Risk Patients

Recurrent Medulloblastoma

Emerging Targeted Therapies in Medulloblastoma

Conclusion

Acknowledgments

References

Index

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