Medulloblastoma is treated primarily with surgical excision followed by radiation therapy and chemotherapy. When there is spinal extension, craniospinal radiation is standard.
Inoperable medulloblastomas are often treated iwth chemotherapy but there is no randomized prospective evidence to support this. This is especially so in adults, in whom this disease is much less common and in whom it appears to behave distinctly differently. 30% of cases occur in adults. In this case, it is autolgous transplantation that appears to be suggested and after resection.
Autologous transplantation of relapsed disease has support from case reports, series and small prospective trials. There are but a few case reports of allogeneic transplantation for medulloblastoma, some of them from the older literature. Autologous transplantation of relapsed disease has support from case reports, series and small prospective trials. There are but a few case reports of allogeneic transplantation for medulloblastoma, some of them from the older literature. Either kind of stem cell transplantation is not recommended by guidelines after initial treatment. NCCN, on the other hand, lists it as an option for relapsed disease. Unfortunately, at that point, stem cells can no longer be collected because of cranispinal radiation having been performed. It is, therefore, reasonable to collect stem cells before craniospinal radiation is administered, for it precludes stem cell collection in the future. When the cancer recurs, an autologous stem cell transplant is then recommended by NCCCN (AMED-3). For this reason, NCCN recommends collecting stem cellls after the initial remission.
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