Consensus guidelines for the management of pediatric medulloblastoma in low and middle-income countries

Authors

  • Naureen Mushtaq Department of Paediatric Oncology, The Aga Khan University, Karachi, Pakistan.
  • Syed Ather Enam Department of Neurosurgery, The Aga Khan University, Karachi, Pakistan.
  • Mohammad Hamza Bajwa Department of Neurosurgery, The Aga Khan University, Karachi, Pakistan.
  • Fatima Mustansir Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, USA.
  • Erum Baig Department of Surgery, University of Pennsylvania, USA.
  • Fatima Gauhar The Aga Khan Medical College and University, Karachi, Pakistan.
  • Afia Arif Department of Paediatric Oncology, The Aga Khan University, Karachi, Pakistan.
  • Ahsan Ali Khan Department of Neurosurgery, The Aga Khan University, Karachi, Pakistan.
  • Syed Ahmer Hamid Department of Paediatrics, The Indus Hospital, Karachi, Pakistan.
  • Gohar Javed Department of Neurosurgery, The Aga Khan University, Karachi, Pakistan.
  • Fatima Mubarak Department of Radiology, The Aga Khan University, Karachi, Pakistan.
  • Bilal Mazhar Qureshi Department of Radiation Oncology, The Aga Khan University, Karachi, Pakistan.
  • Khurram Minhas Department of Histopathology, The Aga Khan University, Karachi, Pakistan.
  • Salman Kirmani Department of Paediatrics, The Aga Khan University, Karachi, Pakistan.
  • Shahzadi Resham Department of Paediatrics, The Aga Khan University, Karachi, Pakistan.
  • Asif Bashir Punjab Institute of Neurosciences, Lahore General Hospital, Pakistan.
  • Irfan Yousaf Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan.
  • Ahmed Gilani Department of Pathology, University of Colorado, Children's Hospital Colorado, USA.
  • Eric Bouffet Department of Haematology/Oncology, The Hospital for Sick Children, Toronto, Canada
  • Pakistan Brain Tumour Consortium: (Authors list at the end of the supplement), +92 (021) 32226443
  • Nouman Mughal Department of Paediatric Oncology, The Aga Khan University, Karachi, Pakistan.

DOI:

https://doi.org/10.47391/JPMA.S3.GNO-14

Abstract

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.
Keywords: Medulloblastoma, neuropathology,
neurosurgery, radiation oncologists, brain neoplasms,
paediatricians, morbidity, genomics

Published

2024-06-09

How to Cite

Naureen Mushtaq, Syed Ather Enam, Mohammad Hamza Bajwa, Fatima Mustansir, Erum Baig, Fatima Gauhar, Afia Arif, Ahsan Ali Khan, Syed Ahmer Hamid, Gohar Javed, Fatima Mubarak, Bilal Mazhar Qureshi, Khurram Minhas, Salman Kirmani, Shahzadi Resham, Asif Bashir, Irfan Yousaf, Ahmed Gilani, Eric Bouffet, Pakistan Brain Tumour Consortium: (Authors list at the end of the supplement), & Nouman Mughal. (2024). Consensus guidelines for the management of pediatric medulloblastoma in low and middle-income countries. Journal of the Pakistan Medical Association, 74(3 (Supple), S116-S125. https://doi.org/10.47391/JPMA.S3.GNO-14

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