Chapters authored
Radiation Therapy in Metastatic Neuroblastoma
Neuroblastoma is the commonest extracranial solid tumor in children, and metastasis at presentation is seen in more than 50% of cases. The role of radiotherapy as a palliative modality in patients with advanced neuroblastoma provides better symptomatic relief. Palliative radiotherapy dose schedules can be given either in single hypofractionation from 4 to 8 Gy or fractionated radiotherapy that can range from 21 to 30.6 Gy. Dose-response relationship trend has been reported in the palliative setting of bone metastasis. Because of the proximity of tumor to critical organs, serious adverse effects can be avoided with conformal techniques. Although currently there is limited data available, new treatments with particle therapies are undergoing clinical evaluation and may offer new hope for good quality of life in these patients.
Part of the book: Nuclear Medicine Physics
Pediatric Medulloblastoma: A Radiation Oncologist Perspective
Pediatric medulloblastomas are radiosensitive and mostly curable tumors if they are non-metastasized. Postsurgery adjuvant radiation therapy remains the cornerstone therapy in the curative intent treatment. In case of children less than three years, pre-irradiation chemotherapy is given to defer radiotherapy till the child is three year old. Introduction of conformal radiotherapy in addition to technical improvements in surgery and radiotherapy, risks definition and molecular analysis of prognostic factors has most likely contributed to the improved survival rates. Children should ideally be referred in time to an appropriate higher center with adequate infrastructure, expertise and radiotherapy facilities for better outcome of the disease.
Part of the book: Brain and Spinal Tumors