Department of Paediatric Oncology, The Aga Khan University, Karachi, Pakistan.
Department of Neurosurgery, The Aga Khan University, Karachi, Pakistan.
J Pak Med Assoc. 2024 Mar;74(3 (Supple-3)):S116-S125. doi: 10.47391/JPMA.S3.GNO-14.
The management of medulloblastoma, a pediatric brain tumor, has evolved significantly with the advent of genomic subgrouping, yet morbidity and mortality remain high in LMICs like Pakistan due to inadequate multidisciplinary care infrastructure. This paper aims to establish evidence-based guidelines tailored to the constraints of such countries. An expert panel comprising neuro-oncologists, neurosurgeons, radiologists, radiation oncologists, neuropathologists, and pediatricians collaborated to develop these guidelines, considering the specific challenges of pediatric brain tumor care in Pakistan. The recommendations cover various aspects of medulloblastoma treatment, including pre-surgical workup, neurosurgery, neuropathology, chemotherapy, radiation therapy, and supportive care. They offer both minimum required and additional optional protocols for more advanced centers, ensuring comprehensive patient management with attention to complications and complexities encountered in Pakistan. The paper's consensus guidelines strive for uniformity in healthcare delivery and address significant gaps in diagnosis, treatment, and follow-up of pediatric medulloblastoma patients.
髓母细胞瘤（一种儿童脑肿瘤）的管理随着基因组亚组化的出现而显著发展，但在巴基斯坦等中等收入和低收入国家，由于缺乏多学科护理基础设施，发病率和死亡率仍然很高。本文旨在为这些国家制定基于证据的指南。一个由神经肿瘤学家、神经外科医生、放射科医生、放射肿瘤学家、神经病理学家和儿科医生组成的专家小组合作制定了这些指南，考虑到巴基斯坦儿童脑肿瘤护理的具体挑战。这些建议涵盖了髓母细胞瘤治疗的各个方面，包括术前评估、神经外科、神经病理学、化疗、放疗和支持性护理。它们为更先进的中心提供了最低要求和额外可选方案，确保全面管理患者，同时关注巴基斯坦遇到的并发症和复杂性。本文的共识指南致力于医疗服务的统一，并解决了儿童髓母细胞瘤患者在诊断、治疗和随访方面的重大差距。
