Treatment Protocols

 

>Assessment, Investigations and the Decision making process


Guidelines for Medical Decompressive Therapy


Intensity Modulated Radiotherapy (IMRT)


Stereotactic Irradiation (SRS and SRT)


Performance Scales

Follow-Up Policy

Primary Treatment Policies


Astrocytic Tumors (Gliomas)

Ependymomas

 

Tumors requiring Craniospinal Radiotherapy

 

Pituitary Tumors

Craniopharyngiomas

Meningiomas

Chordomas

Primary CNS Lymphomas

Spinal Tumors

 

Brain Metastasis


Initial Investigations and Assessment


1. Full history and physical examination as outlined in the Neuro Oncology Data Sheet (NDS). A copy of NDS can be obtained by writing to us.

2. Baseline investigations:
a) Laboratory (we do not carry out any baseline investigations except when indicated as in unknown primary with brain metastases.)
b) Imaging review of all previous imaging

3. Review of histology:

Submit slides with full details to our pathology department Attach outside histopathology report. In cases of NHL, round cell tumors and PNETs or where the diagnoses is doubtful or not correlating with radiological diagnoses, we ask for paraffin blocks or 4-6 unstained slides for immunohistochemistry.

4. Evaluation of physical, functional and psychological status:

All new patients seen in the NeuroOncology Clinics are also evaluated in the simultaneously running BTF clinics, where patients are evaluated for their physical, functional and psychological assessments. Special emphasis is laid on identifying their potential needs during and after treatment and a plan of action charted detailing appropriate steps to meet their and family's needs.


 

The Decision Making Process


All new cases are evaluated by a consultant and a treatment plan is formalized. Patients requiring multidisciplinary postoperative management, those with a diagnostic or therapeutic problem, interesting cases and patients eligible for trial are discussed in the weekly Joint NeuroOncology Meeting (JNOM). JNOM is held every Thursday at 2 pm at ‘Dr. Sirsat Room’, Dept of Pathology, 8th floor, Annexe Bldg.

 

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