I would suggest that you contact Dr. Amar Gajjar at St Jude at [email protected].

Best wishes,

Martine

Thank you so much, Martine! Andree

The treatment includes chemotherapy and in some situations posterior fossa radiotherapy. We have active protocols for the treatment of infants with medulloblastoma at DFCI/Children's Hospital in Boston (617-632-4907). There are also protocols through COG (Children's Oncology Group) and there are many centers in the country that have active brain tumor programs.

Thanks -my question was more about personal experience as we do have protocols and several centers with active brain tumor programs as well. But I appreciate your citations! Andree

First, if possible, avoid radiation. second explore Hedgehog inhibitors, third good luck

Good point about the Hedgehog inhibitors - many thanks! Andree

Its important to keep in mind that although the majority of infants with MB fall into the SHH sub-type, not all do.

The standard treatment of a medullblastoma is surgical resection and neuroaxis and spinal fluid analysis for possible radiation treatment post surgery

First, you have to resect the tumor by surgical procedure. Second, those patients need both chemotherapy and radiotherapy after the correct pathological diagnosis.

The issue of brain radiation in children less than three years of age is not trivial. Strongly suggest you review post-radiation effects in the literature prior to committing to this modality.

Also suggest the doctors at Duke for their opinions.

I agree with you that radiation in children less than three years of age is not trivial. Thanks for your suggestion about Duke! Andree

Hi Andree,

medulloblastoma in small children is not so rare, so there are very well established protocol for each subtype, histology, age and degree of metastasis. The principle of surgery first followed by chemotherapy and at the latest possible time point irradiation however is generally valid.

I am not sure, how you are involved with this question, but picking individual treatment elements rather than discussing the details of the relevant protocol with the treating physician in my experience rarely leads to a better strategy. In Germany all children are treated according to one study guideline and I suspect this is the same in the US.

Matthias

Hi Matthias,

of course we do have plenty of protocols, my question here is more to colleagues here, whose expertise is different from country to country (and therefore following different protocols). As we can see here, some head for chemotherapy, some not.

I'm rather asking for personal experience than for protocols. Thanks, Andree

Hi Andree

We have some experience with intraventricular chemoterapy in small children avoiding rt if posiible. RT/AT is a diferent issue.

Good Luck¡