A Simplified Supine Technique Expedites the Delivery of Effective Craniospinal Radiation to Medulloblastoma – Comparison with Other Techniques in the Literature

Abstract

A 28-year-old man presented to the emergency room with a severe headache of one day's duration. A computerized tomography scan showed a hemorrhagic tumor measuring 3.9 x 4.4 cm in the left cerebellar hemisphere. The resection specimen revealed medulloblastoma. He had two episodes of rebleeding and multiple postoperative issues preventing the use of prone craniospinal radiotherapy. We designed a supine technique for this tall man, which was not complicated to set up. The rapid safe implementation of this technique allowed us to avoid further rebleeding and successfully treat the residual tumor. This technique is the described technique in this case report and is compared to other techniques. At 7.5 years after surgery, he is alive without cancer and with only a mild residual deficit. This case is unusual since the majority of patients with the diagnosis of hemorrhagic medulloblastoma died.

Pediatric Medulloblastoma: A Radiation Oncologist Perspective

“…Advantages of supine position [25] • Target volume coverage is more easily assured and delivery more reproducible.…”