EXPERT CONSENSUS RECOMMENDATIONS FOR THE MANAGEMENT OF POSTERIOR CRANIAL FOSSA TUMORS IN LOW- AND MIDDLE-INCOME COUNTRIES
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Posterior cranial fossa tumors remain one of the most complex problems of modern neuro-oncology, especially in low- and middle-income countries, where diagnostic capabilities, access to multidisciplinary care and long-term follow-up of patients are limited. These tumors are frequently accompanied by occlusive hydrocephalus, neurological deficit and a high risk of persistent functional impairment. This expert consensus presents evidence-based recommendations on the diagnosis, surgical treatment, cerebrospinal fluid diversion procedures, adjuvant therapy and subsequent follow-up of patients with posterior cranial fossa tumors under conditions of limited resources. Particular attention is paid to the importance of maximally safe resection of the tumor, timely neuroimaging, the rational choice of methods for correcting cerebrospinal fluid dynamics and the adaptation of radiotherapy to the capabilities of the local health care system. The features of the management of pediatric patients and of metastatic lesions in adults, as well as the risk factors for persistent hydrocephalus, are considered. The recommendations presented are aimed at improving the survival, functional outcomes and quality of life of patients.
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