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Management of Primary Pediatric CNS Tumors

  • Understanding principles of management for the acute clinical presentation of children with CNS tumors, as well as subsequent therapeutic decision making and management of complications.
  • Knowledge of the accurate diagnosis of pediatric CNS tumors, including: the typical clinical presentation, appropriate diagnostic workup (including pathology, neuro-imaging, and other diagnostic procedures), and prognostic information.
  • Understanding of standard treatment plans (surgery, chemotherapy/biologic therapy, radiation therapy) including the indications for experimental or palliative options.

Management of neurologic disorders associated with CNS tumors and their treatment

  • Ability to anticipate and treat complications to brain tumors and resultant therapies, namely: seizures, ICP, endocrinopathies, CVA, paraneoplastic syndromes, pain/headache management, and assorted treatment-related adverse effects.
  • Familiarity with chemotherapy options, their administration, adverse reactions, and benefits/limitations.
  • Understanding of the psychologic/psychiatric/cognitive deficits accompanying brain tumors and associated treatment, including the importance of caregiver involvement/participation in therapy.
  • Comprehension of resources for palliative management and their appropriate incorporation into the treatment plan.

Clinical/Bench Research

  • Pediatric neuro-oncology is a subspecialty which relies heavily on both bench and clinical research to improve outcomes which are sometimes dismal. The fellow will be expected to engage in either bench or clinical research during the fellowship.
  • Develop understanding of clinical trial availability, development, and limitations.
  • Engage in research resulting in abstract/poster/paper presentation.
  • Become familiar with the process of clinical trial development in single-institutions, consortia, or industry sponsored contexts.
  • Introduction to the pediatric neuro-oncology community via attendance at appropriate conferences and interfaces with other neuro-oncologists.

The above educational goals will be accomplished via several discrete mechanisms

Mandatory educational sessions

  • Neuro-oncology intake and neuro-radiographical sessions – weekly
  • Didactic neuro-oncology fellow educational sessions – bimonthly
  • Journal club – monthly
  • Neuro-oncology tumor multidisciplinary tumor boards – bi-monthly

Clinical exposure

  • Assessment and treatment planning for pediatric neuro-oncology patients – bi-weekly
  • Presentation and discussion of patients at tumor boards, intake rounds, and with outside consultants

Clinical rotations

  • Pediatric Palliative Care (PANDA) rotation – 1-2 weeks
  • Neuropathology – 1-2 weeks
  • Radiation oncology – Sibley Memorial Proton Facility, 1-2 weeks
  • Neuroradiology – 1 week discrete rotation
  • Neurosurgical – ad hoc
  • Neuropsychology – 1 week

National conferences/meetings – the fellow will be encouraged to present and attend at least one national conference/meeting during each year.

Fellows will be expected to engage in clinical or bench research with program guidance.