Practice Patterns Among Radiation Oncologists Treating Pediatric Patients With Proton Craniospinal Irradiation

Scoliosis in Children Treated With Photon Craniospinal Irradiation for Medulloblastoma

“…6 Others have recommended coverage of the entire vertebral body to full prescription doses in skeletally immature patients. 8,9 Perhaps a vertebral body sparing approach which minimizes dose to the vertebral primary ossification centers might be more useful to prevent scoliosis in these young patients. 17 There are some limitations in this study.…”

“…Based on a recent survey, there is no standardized approach to proton-based CSI with respect to vertebral coverage. 8 With photon CSI, a gradual dose falloff of 2% to 4% per cm of tissue is typically observed with 6-MV photons and would deliver a relatively homogeneous dose to the entire vertebral body. 9 Hence, with photon CSI, there is less concern regarding spinal asymmetry, although long-term data are lacking to substantiate this statement.…”

Precision based approach to tailoring radiotherapy in the multidisciplinary management of pediatric central nervous system tumors

“… 128 To reduce the risk of scoliosis from partial irradiation of the vertebral body, common practice is to irradiate the entire vertebral body. 129 …”