Craniospinal Radiotherapy in an Advanced Technique

Abstract

The described technique is now well established, feasible and leads to less risk of dose uncertainties.

Curative treatment for central nervous system medulloepithelioma despite residual disease after resection

“…Therefore, in cases with metastatic disease the application of intensive radiotherapy should be considered. Newly developed techniques could minimize problems of matching fields and maximize precision of craniospinal radiotherapy in future [9]. Moreover the potential clinical application of new chemotherapeutic agents merits further investigation [23].…”

Pineal Parenchymal Tumors

“…Interstitial brachytherapy for the treatment of malignant diseases is well established [7,12,27,28,30,34,37,38] but reports in the literature addressing interstitial irradiation of these tumors using stereotactic 125 I seed implantation are rare. Taken together, they amount to three pineoblastoma cases [4,29] and four patients with pineocytoma [22].…”

Acute toxicity of craniospinal irradiation with volumetric‐modulated arc therapy in children with solid tumors

“…In older children, the length of the target volume encompassing the brain and thecal sac may exceed 80 cm, which exceeds the maximal linear accelerator field size. Conventionally, the target volume is split such that the brain is treated with two opposed lateral fields which are matched to a single direct posterior field to the spine . The junction between the fields is moved periodically to avoid dosimetric hot or cold spots over the spinal cord due to setup or treatment uncertainties.…”

“…Conventionally, the target volume is split such that the brain is treated with two opposed lateral fields which are matched to a single direct posterior field to the spine. [7][8][9] The junction between the fields is moved periodically to avoid dosimetric hot or cold spots over the spinal cord due to setup or treatment uncertainties. These uncertainties are compounded by challenges in patient positioning, with both prone and supine CSI techniques being used widely.…”