Preliminary results of conformal radiation therapy for medulloblastoma Journal Article
| Authors: | Merchant, T. E.; Happersett, L.; Finlay, J. L.; Leibel, S. A. |
| Article Title: | Preliminary results of conformal radiation therapy for medulloblastoma |
| Abstract: | Radiation therapy for medulloblastoma consists of postoperative irradiation of the intracranial and spinal subarachnoid volume with an additional boost to the primary site of disease in the posterior fossa. The entire posterior fossa is usually included in the boost volume. Conformal radiation therapy techniques may be used to boost the primary site alone and substantially reduce the dose received by normal tissues, including the supratentorial brain, the middle and inner ear, and the hypothalamus. Using these techniques to irradiate only the tumor bed or residual rumor and not the entire posterior fossa represents a new paradigm in the treatment of medulloblastoma. In this study, we examine the use of conformal radiation therapy in the treatment of 14 patients with medulloblastoma. These patients were treated with multiple static, individually shaped, noncoplanar beams directed at the primary site after craniospinal irradiation. Excluding two patients who had previously received irradiation to the posterior fossa, the mean dose delivered to the primary site was 5715 cGy. Among the medulloblastoma patients (n=10) who received immediate postoperative radiation therapy, no failures have occurred with a median follow-up of 42 months (range from 30 to 54 months). To demonstrate the differences in the distribution of dose to normal tissues when comparing conventional and conformal techniques, dose-volume histograms of the total brain, middle and inner ear, hypothalamus, and temporal lobe were created and presented for an example case. The neurologic, neuroendocrine, and neurocognitive outcome for patients with medulloblastoma may be influenced with the use of conformal radiation therapy. The use of these techniques should be formally tested in prospective studies of rigorously staged patients with failure rate monitoring. Neuro-Oncology 1, 177-187, 1999 (Posted to Neuro-Oncology [serial online], Doc. 98-01, June 15, 1999. URL 〈neuro-oncology.mc.duke.edu〉). |
| Keywords: | adult; child; preschool child; treatment outcome; child, preschool; retrospective studies; multimodality cancer therapy; adjuvant therapy; radiation dose; chemotherapy, adjuvant; combined modality therapy; radiotherapy, adjuvant; follow up; follow-up studies; neoplasm recurrence, local; radiotherapy dosage; retrospective study; skull irradiation; cranial irradiation; tumor recurrence; adjuvant chemotherapy; medulloblastoma; cognitive defect; radiotherapy, conformal; cognition disorders; computer assisted radiotherapy; cerebellar neoplasms; posterior fossa; perception deafness; hearing loss, sensorineural; cerebellum tumor; learning disorder; subarachnoid space; humans; human; male; female; article; cranial fossa, posterior; learning disorders |
| Journal Title: | Neuro-Oncology |
| Volume: | 1 |
| Issue: | 3 |
| ISSN: | 1522-8517 |
| Publisher: | Oxford University Press |
| Date Published: | 1999-07-01 |
| Start Page: | 177 |
| End Page: | 187 |
| Language: | English |
| PUBMED: | 11550312 |
| PROVIDER: | scopus |
| PMCID: | PMC1920746 |
| DOI: | 10.1093/neuonc/1.3.188 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 16 August 2016 -- Source: Scopus |
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