Atypical Teratoid/Rhabdoid Tumor (AT/RT) is a rare and aggressive type of pediatric brain cancer that typically affects children under the age of three, though it can occur at any age. Characterized by rapid growth and a high risk of spreading within the central nervous system, AT/RT requires urgent and comprehensive medical intervention. In India, world-class oncology centers offer advanced, multidisciplinary treatment for AT/RT that includes surgery, chemotherapy, radiation therapy, stem cell transplantation, and access to cutting-edge clinical trials. These treatments are delivered by highly experienced specialists such as Dr. Anurag Bahl, a leading expert in pediatric neuro-oncology in nIndia. One of the key reasons international patients choose India is the affordability of care—without compromising on quality. The average cost for complete AT/RT treatment in India ranges between USD 7,500 to 10,000, significantly lower than the USD 80,000 to 150,000 typically charged in the USA or USD 25,000 to 40,000 in Thailand. This cost-effective, high-quality care, combined with personalized support for international patients, makes India a trusted destination for AT/RT treatment.
Atypical Teratoid/Rhabdoid Tumor (AT/RT) is a rare and aggressive form of cancer that primarily affects the central nervous system (CNS), including the brain and spinal cord. It is most commonly diagnosed in children under the age of three but can occur at any age. AT/RTs are classified as Grade IV tumors, indicating a high-grade, fast-growing malignancy.
The symptoms of AT/RT largely depend on the location of the tumor in the brain or spinal cord, and the age of the patient. Since this tumor commonly affects infants and young children, symptoms may be subtle and easily mistaken for common childhood illnesses. However, the disease progresses rapidly, making early recognition crucial.
| Location | Associated Symptoms |
|---|---|
| Supratentorial (cerebral hemispheres) | Hemiparesis, visual disturbances, behavioral changes |
| Infratentorial (posterior fossa/cerebellum) | Ataxia, coordination problems, nystagmus, cranial nerve palsies |
| Spinal cord involvement | Limb weakness, back pain, bladder or bowel dysfunction |
Timely and accurate diagnosis of AT/RT is critical due to its aggressive behavior and similarity to other CNS tumors in children. The diagnostic process combines neuroimaging, pathology, immunohistochemistry, and molecular testing to confirm AT/RT and plan the treatment strategy.
| Diagnostic Tool | Purpose |
|---|---|
| MRI Brain + Spine (with contrast) | Gold-standard imaging to determine tumor size, location, and CNS/spinal involvement. Crucial for staging and surgery planning. |
| Histopathology + IHC for INI1 | Microscopic examination of tumor cells and immunohistochemistry showing loss of INI1 (SMARCB1)—the definitive diagnostic marker for AT/RT. |
| CSF Cytology (Lumbar puncture) | Detects tumor cells in cerebrospinal fluid, indicating leptomeningeal dissemination. |
| Genetic Testing (SMARCB1/SMARCA4) | Confirms molecular signature of AT/RT. Also helpful in familial screening and counseling. |
| Baseline Blood Tests | CBC, liver/renal profile, and electrolytes to assess the child's overall health before starting chemotherapy or surgery. |
Atypical Teratoid/Rhabdoid Tumor (AT/RT) is a rare and aggressive cancer primarily affecting the central nervous system (CNS) of infants and young children. Although the exact cause is not fully understood, advances in molecular genetics have revealed important clues about its origins and risk factors.
The development of AT/RT is strongly linked to genetic mutations, particularly:
These genetic changes result in uncontrolled cell proliferation, leading to tumor formation.
Note: These mutations are typically not inherited, but in 10–15% of cases, they may be part of a genetic syndrome known as rhabdoid tumor predisposition syndrome (RTPS).
While AT/RT is a rare condition, some factors are associated with increased risk:
| Risk Factor | Details |
|---|---|
| Age | Most cases occur in children under 3 years of age; rare in adults. |
| Genetic Predisposition (RTPS) | Children born with germline mutations in SMARCB1/SMARCA4 have a higher risk. |
| Family History | Very rare, but a positive family history of rhabdoid tumors may suggest hereditary risk. |
| Male Gender | Slightly more common in boys than girls. |
If a child is diagnosed with AT/RT, genetic counseling and testing for SMARCB1 or SMARCA4 mutations may be recommended.
A multimodal approach is essential, typically involving:
| Common Agents | Schedule |
|---|---|
| Vincristine, Cyclophosphamide | Weeks 1–6, alternating with Cisplatin, Etoposide |
| Methotrexate (high-dose) | Optional in selected regimens |
| Intrathecal Chemotherapy | Methotrexate or Cytarabine for CSF prophylaxis |
Note: Chemotherapy is dose-adjusted based on age and weight.
Dr. Ankur Bahl, Senior Director of Medical Oncology at Fortis Memorial Research Institute (FMRI), Gurugram, is one of India’s most trusted names in pediatric and adult neuro-oncology. His leadership in managing rare and aggressive CNS tumors like Atypical Teratoid/Rhabdoid Tumors (AT/RT) makes him a preferred choice for families seeking specialized care in India and abroad.
Dr. Bahl collaborates closely with pediatric neurosurgeons, radiation oncologists, and stem cell transplant specialists to ensure a comprehensive, personalized treatment approach for each AT/RT case. His involvement spans:
| Treatment Component | India (USD) | Turkey (USD) | USA (USD) |
|---|---|---|---|
| Brain Surgery (Craniotomy) | $4,000 – $8,000 | $7,000 – $12,000 | $40,000 – $70,000 |
| Awake Craniotomy (if applicable) | $7,000 – $10,000 | $10,000 – $15,000 | $60,000 – $90,000 |
| Radiation Therapy (IMRT) | $5,000 | $15,000 | $30,000 – $50,000 |
| Radiation IGRT | $6,000 | $15,000 | $30,000 – $50,000 |
| Radiation V-MAT | $6,500 | $15,000 | $30,000 – $50,000 |
| Chemotherapy (Multi-agent cycles) | $700 – $1,500 | $1,000 – $2,000 | $10,000 – $50,000 |
| High-Dose Chemo + Stem Cell Rescue (HDC-ASCR) | $18,000 – $25,000 | $30,000 – $45,000 | $150,000 – $250,000 |
| Diagnostics (MRI, Biopsy, IHC, Genetic Tests) | $500 – $1,000 | $800 – $1,200 | $3,000 – $6,000 |
India's hospitals offer dedicated services for international patients, including:
AT/RT is an aggressive tumor with a generally poor prognosis. However, early detection and a comprehensive treatment plan can improve outcomes.
| Risk Category | Estimated 2-Year Survival |
|---|---|
| Gross total resection + Radiation | 60–70% |
| Subtotal resection, <3 years age | 20–40% |
| Disseminated disease at diagnosis | <20% |
Follow-Up Care:
Regular monitoring through imaging and clinical evaluations is crucial to detect any recurrence. Long-term follow-up also addresses potential late effects of treatment, especially in children.