Management and Treatment of Pediatric Spinal Cord Ependymoma: Results from an International Multi-Institutional Review

Abstract

fractions. All institutions customized their lung blocks however the thickness varied to provide 50 to 70% transmission. 67% specified mid lung dose whereas 37% did not specify lung dose for lateral TBI. Of the 67% who specified mid lung dose, only 33% used CT or 2D imaging to estimate the mid lung dose. No CT planning was done for lateral TBI. 100% of the physician responders answered "yes" to redefining current TBI techniques and > 75% supported the investigation of new TBI techniques in an effort to lower the lung doses. Conclusion: The practice of TBI amongst COG institutions is very heterogeneous. Dose accuracy is difficult to assess as few perform CT-based planning. These findings warrant caution to be exercised when interpreting radiation related efficacies and toxicities when multi-institutional clinical studies are carried out. COG is currently undertaking steps to standardize the practice of TBI.