Complex treatment of primary brain neuroblastoma with four local reccurences for period of 5 years – clinical case from our practice
- Marinova, R. Georgiev, I. Mihaylova, M. Belcheva
We present a clinical case of 17 years old girl with primary brain neuroblastoma (supratentorial primitive neuroectodermal tumor – PNET in right temporo-parietal brain region). Complex treatment has been applied, including subtotal operation, standard fractioned cranio-spinal external beam radiotherapy with boost up to 56 Gy in the locus of the tumor remnant and 6 courses of adjuvant chemotherapy with Carboplatine and Etoposid. Despite the applied local treatment methods (radical surgery, standard fractioned cranio-spinal external beam radiotherapy and radio-surgery with single total dose of 14 Gy), four recurrences have appeared for period of 5 years in the locus of the primary tumor. The risk of appearance of local recurrences, necessitating reoperations, chemotherapy, bone marrow transplantation of stem cells and radio-surgery was discussed. We are also discussing the radio sensitivity of the PNET and the possibilities for overcoming it with implementation of hyper fractioned cranio-spinal external beam radiotherapy in combination with chemotherapy, followed by bone marrow transplantation of stem cells.
Key words: PRIMARY BRAIN NEUROBLASTOMA. RADIO SENSITIVITY. CRANIO-SPINAL EXTERNAL BEAM RADIOTHERAPY. ADJUVANT CHEMOTHERAPУ