Hyperfractionated craniospinal radiotherapy and adjuvant chemotherapy for children with newly diagnosed medulloblastoma and other primitive neuroectodermal tumors

Radiotherapy for medulloblastoma in children: A perspective on current international clinical research efforts

“…In one study, low dose HFRT to 30 Gy CSI without chemotherapy resulted in an unacceptably high rate of relapse in the supratentorial brain and leptomeninges [18]. Other studies, however, confirmed the feasibility of the approach [19] and one suggested increased efficacy in high-risk patients [20]. The UKCCSG, HIT, and SFOP all plan to investigate the role of HFRT in average risk patients.…”

Extended Abstracts from the Eighth International Meeting on Progress in Radio-Oncology ICRO / ÖGRO 8

“…Allen et al [16] treated 23 patients with primitive neuroectodermal brain tumors (19 of whom had medulloblastoma, with 15 good-risk patients) using both HFRT with 72 Gy to primary site and 36 Gy to cranial axis and adjuvant chemotherapy. With a median follow up of 75 months, fourteen patients were in remission.…”

“…Definitive treatment is delayed until symptoms arise or progression is documented. From three randomized radiotherapy trials for patients with a low grade glioma it can be concluded that radiotherapy can be safely deferred until disease progression, and that radiation doses above 45-50 Gy do not confer additional benefit [16][17][18]. Adjuvant PCV chemotherapy after radiation in high-risk low-grade glioma patients failed to improve the outcome in a recently reported randomized RTOG trial [19].…”

Évolution de la prise en charge des médulloblastomes de l’enfant et de l’adulte

“…Une autre piste de stratégie thérapeutique explorée pour limiter les séquelles de l'irradiation craniospinale a été l'hyperfractionnement [75]. Le bien fondé en est l'absence de réparation et de repopularisation des tissus tumoraux entre deux séances réalisées le même jour, alors que les tissus sains ont la possibilité inverse.…”