dulloblastoma DiagnosisYou will meet with your medical team to discuss the treatment options, details of the protocol, the suggested timeline and the next steps. At this time you will have many questions, may like to explore 2nd opinions, want to understand the science and learn the prognosis of this diagnosis.
There are different types of treatment for children who have dulloblastoma and other central nervous system (CNS) embryonal tumors. The treatment options are dependent on age, stage, and subtype of Medulloblastoma and the details will be listed on your protocol and discussed with you with your medical team. There are five most common used treatments for pediatric dulloblastoma.
Surgery is used to diagnose and treat childhood dulloblastoma and other CNS embryonal tumors as described in the General Information section of this summary.
A cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. External radiation therapy uses a machine outside the body to send radiation toward the area of the body with cancer Certain ways of giving radiation therapy can help keep radiation from damaging nearby healthy tissue.
These types of radiation therapy include the following:
PHOTON:Conformal radiation therapy: Conformal radiation therapy is a type of external radiation therapy that uses a computer to make a 3-dimensional (3-D) picture of the tumor and shapes the radiation beams to fit the tumor. This allows a high dose of radiation to reach the tumor and causes less damage to nearby healthy tissue.
PROTON:Stereotactic radiation therapy: Stereotactic radiation therapy is a type of external radiation therapy. A rigid head frame is attached to the skull to keep the head still during the radiation treatment. A machine aims radiation directly at the tumor, causing less damage to nearby healthy tissue. The total dose of radiation is divided into several smaller doses given over several days. This procedure is also called stereotactic external-beam radiation therapy and stereotaxic radiation therapy
A cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). Although most cannot, some chemotherapy drugs can cross the blood-brain barrier and reach tumor cells in the brain.
When chemotherapy is placed directly into the cerebrospinal fluid, it is called intrathecal chemotherapy. Intraventricular chemotherapy is a treatment in which anticancer drugs are placed into the ventricles (fluid-filled cavities) of the brain. Combination chemotherapy is treatment using more than one anticancer drug. The way the chemotherapy is given depends on the type of cancer being treated.
High doses of chemotherapy are given to kill cancer cells. Healthy cells, including blood-forming cells, are also destroyed by the cancer treatment. Stem cell transplant is a treatment to replace the blood-forming cells. Stem cells (immature blood cells) are removed from the blood or bone marrow of the patient or a donor and are frozen and stored. After the patient completes chemotherapy, the stored stem cells are thawed and given back to the patient through an infusion. These reinfused stem cells grow into (and restore) the body’s blood cells.
A type of treatment that uses drugs or other substances to identify and attack specific cancer cells. Targeted therapies usually cause less harm to normal cells than chemotherapy or radiation therapy do. Signal transduction inhibitors: This treatment blocks signals that are passed from one molecule to another inside a cell. Blocking these signals may kill cancer cells. Vismodegib is a type of signal transduction inhibitor that may be used to treat recurrent dulloblastoma in children who have finished growing. Targeted therapy is being studied for the treatment of childhood dulloblastoma and other CNS embryonal tumors that have recurred (come back).
Immunotherapy offers promising options for treating brain cancer, which is traditionally treated with chemotherapy, radiation therapy, and surgery.
Immunotherapy is class of treatments that take advantage of a person’s own immune system to help kill cancer cells. FDA-approved immunotherapy options for brain and nervous system cancers. Immunomodulators (GM-CSF, TMB-H) & Targeted Antibodies (Avastin, Unituxin).
If your child receives standard treatment, you will be given a written copy of the treatment plan, called a protocol. A protocol has a list of ingredients, the amounts to use, and the order to use them in so the protocol has the best chance for success. The protocol lists the treatments, drugs, dosages, and tests for each segment of treatment and follow-up. If your child is enrolled in a clinical trial, you will receive a copy of the short protocol but can obtain the entire protocol document by asking for it.
The portion of the protocol devoted to the schedule for treatments and tests may be longer than 20 pages. The family may also be given an abbreviated version (one to two pages) for quick and easy reference on a daily basis. This abbreviated part of the protocol is frequently called the “roadmap.” Parents and teenage patients should review these documents carefully with the treatment team to be certain they understand them. Protocols are based on your diagnosis- risk classification, group + resection (full or partial), age and treating institution.
Sponsor
Protocol detail link
Ages
Rounds/Timeline
New or Recurrent
Treatment Modality
Key Features
Treatment is the first line of defense for combatting brain cancer; however there are side effects associated with the different lines of defense. Below are some effects that are most common side effects for standard chemotherapy agents like cyclophosphamide, cisplatin, vincristine, etoposide, methotrexate, CCNU, radiation and surgery. *For side effects for clinical trials or phase 1 drugs please consult with your treatment team regarding the specific therapy to dulloblastoma patients.
The acute toxicities of chemotherapy and infection can be life threatening. Great care is taken to minimize these risks, and fastidious supportive care is essential: Chemotherapy may need to be delayed or reduced to allow tolerance of the regimen. Procedures or surgeries are sometimes necessary/suggested to assist with treatment or to aid in wellness and commonly used complimentary care may be helpful (however this must always be carefully reviewed with your medical team.)
