Medulloblastoma in children: A correlation between staging and results of treatment

Harisiadis, Leon; Chang, Chu H.

doi:10.1016/0360-3016(77)90181-x

Cited by 192 publications

(66 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The majority of these embryonal tumours are located in the posterior fossa and classified as medulloblastomas. The tumour is characterised by a high frequency of seeding or metastases; up to 40% have been reported [1]. The PNETs are usually sensitive to both chemo-and radiotherapy.…”

mentioning

confidence: 99%

Does electron and proton therapy reduce the risk of radiation induced cancer after spinal irradiation for childhood medulloblastoma? A comparative treatment planning study

Björk‐Eriksson

Nill

et al. 2005

Acta Oncologica

View full text Add to dashboard Cite

show abstract

mentioning

confidence: 99%

Does electron and proton therapy reduce the risk of radiation induced cancer after spinal irradiation for childhood medulloblastoma? A comparative treatment planning study

Björk‐Eriksson

Nill

et al. 2005

Acta Oncologica

View full text Add to dashboard Cite

show abstract

“…Several studies have shown the adverse effects of craniospinal radiation therapy on intellectual abilities and endocrine function [5][6][7]. Unfortunately, attempts to decrease mor bidity by lowering the dose of craniospinal radiation have led to increased recurrences outside the primary site [3]. Hyperfraetionated neuraxis radiation has been proposed as an alternative to conventional radiation therapy be cause the delayed effects of radiation on the C N S are dependent more on fraction size than on time [13], It is also believed that smaller doses will reduce the amount of sublethal radiation injury.…”

Section: Discussionmentioning

confidence: 99%

“…Definitive treatment of medullo blastoma requires not only surgical resection but also postoperative radiation directed to the entire neuraxis because of the tumor's propensity for central nervous sys tem (CNS) seeding. Moreover, doses of at least 50 Gy must be delivered to the posterior fossa to obtain local control at the primary site [1][2][3][4]. These higher doses carry significant risk of late effects, especially when considering the developing nervous systems of the majority of pa tients, whose median age is 5.6-6 years [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Hyperf ractionated Craniospinal Radiation in Medulloblastoma

Marymont

Geohas²,

Tomita

et al. 1996

Pediatr Neurosurg

View full text Add to dashboard Cite

From 1986 to 1991, 13 patients at Northwestern Memorial Hospital were entered onto a pilot study designed to test the feasibility of treating children with meduUoblastoma (11 patients) or primitive neuroectodermal tumors of the cerebral hemispheres (2 patients) with hyperfractionated craniospinal radiotherapy (HFxRT). Follow-up times ranged from 10 to 96 months with a median of 53 months. The patients were prospectively divided among three treatment arms depending on prior treatment history, if any, and degree of surgical resection. The 3 patients in group I had undergone gross total resection of the primary site, receiving 64.8 Gy to the primary site and 31.2 Gy directed to the craniospinal axis (CSA). Of these 3 patients, patient 1 had residual disease in the thoracic spine at T-10. The 8 patients in group II, who had gross residual disease remaining at the primary site, received 72 Gy to the primary site and 34 Gy to the CSA. Five of these eight patients in group II also received 8-in-1 chemotherapy. The 2 patients in group III had already failed chemotherapy and were then treated with 60 Gy to the primary site and 26 Gy to the CSA. Of the 11 patients in groups I and II, 7 of the 11 (64%) have never recurred. Two of the three group-I patients have not recurred, and 5 of the 7 group-II patients have not recurred. In addition, patient 7 (group II) remains alive after salvage with bone marrow transplant, following a local failure bordering the tentorium. Unfortunately, neither of the group-III patients could be salvaged with HFxRT. Acute/subacute toxicities included 7 cases of external auditory canal or skin desquamation, 2 cases of postradiation somnolence, and 1 case each of poor wound healing and neutropenia. Chronic toxicities included hypothyroidism in 2 patients and growth problems in 2 patients. Neuropsychologic complications affected only the 3 youngest patients in the study. Three patients developed neurologic sequelae attributed to radiation, including 1 with progressive urinary incontinence, 1 who developed a transient ischemic attack, and 1 who became progressively ataxic. Our research, although based on a small number of patients, suggests that hyperfractionated radiation therapy to craniospinal access is feasible and that the survival results are favorable. This treatment strategy should be further explored in a phase-III randomized trial.

show abstract

“…The results reported provide a framework for further volume reduction in these patients and important insight and considerations in attempting to treat patients using newer guidelines. 29 no evidence of dissemination by MRI of the brain and spine or CSF cytology; no prior radiation or chemotherapy;score of 0-3 on the Eastern Cooperative Oncology Group performance scale; Informed consent was obtained from all patients, parents, or legal guardians.…”

Section: Introductionmentioning

confidence: 99%

Multi-Institution Prospective Trial of Reduced-Dose Craniospinal Irradiation (23.4 Gy) Followed by Conformal Posterior Fossa (36 Gy) and Primary Site Irradiation (55.8 Gy) and Dose-Intensive Chemotherapy for Average-Risk Medulloblastoma

Merchant¹,

Kun²,

Krasin³

et al. 2008

International Journal of Radiation Oncology*Biology*Physics

153

View full text Add to dashboard Cite

Purpose/Objective-Limiting neurocognitive sequelae of radiation therapy (RT) has been an objective in the treatment of medulloblastoma (MB). Conformal RT to less than the entire posterior fossa (PF) after craniospinal irradiation (CSI) may reduce neurocognitive sequelae and requires evaluation. October 1996 and August 2003, 86 patients, 3-21 years of age, with newly diagnosed, average-risk MB were treated on a prospective, IRB-approved, multi-institution trial of risk-adapted RT and dose-intensive chemotherapy. RT began within 28 days of definitive surgery and consisted of CSI (23.4 Gy), conformal PF RT (36.0 Gy) and primary site RT (55.8 Gy). The planning target volume for the primary site included the post-operative tumor bed surrounded by an anatomically confined margin of 2 cm which was then expanded with a geometric margin of Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Materials/Methods-Between CONFLICT OF INTEREST NOTIFICATION:There are no conflicts of interest with the authors or materials in this manuscript. NIH Public Access NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript 0.3-0.5 cm. Chemotherapy was initiated 6 weeks after RT and included 4 cycles of high-dose cyclophosphamide, cisplatin and vincristine.Results-With a median follow-up of 61.2 months (5.2-115.0 months), the estimated 5-year eventfree survival and cumulative incidence of PF failure were 83.0% ± 5.3% and 4.9% ± 2.4% (±SE), respectively. Targeting guidelines used in this study resulted in a mean reduction of 13% in the volume of the PF receiving doses above 55Gy compared to conventionally planned RT. Reductions in dose to the temporal lobes, cochleae and hypothalamus were statistically significant.Conclusions-This prospective trial demonstrates that irradiation of less than the entire PF after 23.4 Gy CSI for average-risk MB results in disease control comparable to treatment of the entire PF.

show abstract

Medulloblastoma in children: A correlation between staging and results of treatment

Cited by 192 publications

References 13 publications

Does electron and proton therapy reduce the risk of radiation induced cancer after spinal irradiation for childhood medulloblastoma? A comparative treatment planning study

Does electron and proton therapy reduce the risk of radiation induced cancer after spinal irradiation for childhood medulloblastoma? A comparative treatment planning study

Hyperf ractionated Craniospinal Radiation in Medulloblastoma

Multi-Institution Prospective Trial of Reduced-Dose Craniospinal Irradiation (23.4 Gy) Followed by Conformal Posterior Fossa (36 Gy) and Primary Site Irradiation (55.8 Gy) and Dose-Intensive Chemotherapy for Average-Risk Medulloblastoma

Contact Info

Product

Resources

About