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Adult Medulloblastoma

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Adult CNS Radiation Oncology

Abstract

Medulloblastoma is a highly cellular malignant embryonal neoplasm of the cerebellum that is more common in children than adults. The incidence in adults is approximately 0.6–1 cases per million. Patients with medulloblastoma demonstrate a combination of signs and symptoms caused by increased intracranial pressure and cerebellar dysfunction that evolve over a period of weeks to a few months. Standard staging procedures include diagnostic imaging with MRI of the brain and spine as well as CSF fluid cytology. Medulloblastomas are staged by the Chang staging system into average-risk and high-risk patients based on the extent of residual disease or presence of metastatic disease (M-positive disease). Though previously classified histologically, the latest WHO classification has incorporated molecular characteristics to stratify medulloblastoma into four subtypes (WNT-activated, SHH-activated TP53-wt, SHH-activated TP53mut, non-SHH/non-WNT (groups 3 and 4)). Adult patients with medulloblastoma are frequently treated according to various pediatric protocols. The combination of surgery, craniospinal irradiation, and posterior fossa boost irradiation and chemotherapy in concurrent and adjuvant settings has been shown to be viable in both retrospective and prospective studies.

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Authors and Affiliations

  1. Department of Radiation Oncology, Keck School of Medicine of USC, Los Angeles, CA, USA

    Anthony Pham

  2. Department of Radiation Oncology, Keck School of Medicine of USC, Norris Cancer Hospital, Los Angeles, CA, USA

    Kenneth Wong & Eric L. Chang

  3. Department of Radiation Oncology, Children’s Center for Cancer and Blood Diseases, Children’s Hospital Los Angeles, Los Angeles, CA, USA

    Kenneth Wong

  4. Department of Radiation Oncology, UT MD Anderson Cancer Center, Houston, TX, USA

    Eric L. Chang

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  1. Anthony Pham
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Correspondence to Anthony Pham .

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Editors and Affiliations

  1. Department of Radiation Oncology, Keck School of Medicine of USC, Norris Cancer Hospital, Los Angeles, California, USA

    Eric L. Chang

  2. Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota, USA

    Paul D. Brown

  3. Department of Radiation Oncology, University of Washington Medical Center, Seattle, Washington, USA

    Simon S. Lo

  4. Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada

    Arjun Sahgal

  5. Department of Radiation Oncology, Taussig Cancer Institute Cleveland Clinic, Cleveland, Ohio, USA

    John H. Suh

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Pham, A., Wong, K., Chang, E.L. (2018). Adult Medulloblastoma. In: Chang, E., Brown, P., Lo, S., Sahgal, A., Suh, J. (eds) Adult CNS Radiation Oncology. Springer, Cham. https://doi.org/10.1007/978-3-319-42878-9_27

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