Gaur S, Kumar S S, Balasubramaniam P
Department of Radiation Oncology, Barnard Institute of Radiation Oncology, Rajiv Gandhi Government General Hospital and Madras Medical College, Chennai, Tamil Nadu, India.
Indian J Cancer. 2015 Oct-Dec;52(4):575-8. doi: 10.4103/0019-509X.178404.
Medulloblastoma is an embryonal tumor with aggressive behavior and is more commonly seen in children than adults. The aim of this study was to determine the epidemiological patterns of medulloblastoma in a tertiary care center in Southern India.
It is a retrospective study, in which the records of all the clinically diagnosed medulloblastoma cases in the last 10 years (2002-2012) were analyzed.
A total of 58 cases were found, with the mean age at diagnosis being 10 years. There was a slight predilection for the male sex (58.62%). The first presenting symptom was mostly related to raise intracranial pressure and the mean duration of symptoms was 200 days. Nearly, 89.6% of patients were in Stage 0 and had a central tumor location. Multimodality treatment included surgery followed by craniospinal irradiation up to 36 gray followed by posterior fossa boost up to 54 gray. Median radiation therapy duration was 6.5 weeks and concurrent single agent vincristine was the most common chemotherapy used. Most of the patients showed only a partial response to treatment, mainly because of large tumors at presentation, which could be attributed to the lack of awareness, delayed medical attention and poor follow-up.
Early diagnosis and treatment is the key to management of medulloblastoma, which still needs to be achieved. Bulky tumors have a poor outcome, efforts should be aimed at complete surgery and giving risk stratification based treatment. Resources need to be allocated to make more conformal methods of radiotherapy available, which will decrease the growth abnormalities and cognitive impairments.
髓母细胞瘤是一种具有侵袭性的胚胎性肿瘤，在儿童中比成人更常见。本研究的目的是确定印度南部一家三级医疗中心髓母细胞瘤的流行病学模式。
这是一项回顾性研究，分析了过去10年（2002 - 2012年）所有临床诊断为髓母细胞瘤病例的记录。
共发现58例病例，诊断时的平均年龄为10岁。男性略占优势（58.62%）。首发症状大多与颅内压升高有关，症状的平均持续时间为200天。近89.6%的患者处于0期，肿瘤位于中心部位。多模式治疗包括手术，随后进行全脑全脊髓照射至36格雷，然后后颅窝加量照射至54格雷。中位放疗持续时间为6.5周，同时使用单药长春新碱是最常用的化疗方法。大多数患者对治疗仅表现出部分反应，主要原因是就诊时肿瘤较大，这可能归因于意识缺乏、医疗关注延迟和随访不佳。
早期诊断和治疗是髓母细胞瘤管理的关键，这一点仍有待实现。巨大肿瘤预后较差，应努力实现完整手术并给予基于风险分层的治疗。需要分配资源以提供更多适形放疗方法，这将减少生长异常和认知障碍。
