Radiation for medulloblastoma adjusted to prevent recurrence to the cribriform plate region

Abstract

In a recent survey of the recurrence pattern in 40 medulloblastoma patients treated at Memorial Hospital between 1970 and 1979, 15% of all recurrences were in the region of the cribriform plate, which is an area that is undertreated with commonly employed radiation therapy techniques. The authors, therefore, modified their technique to increase the dose in this area. They report on the initial results in 15 subsequent patients treated with this modification. Ten of the 15 patients had localized tumors (Groups I and II) and 8 of these patients are alive disease‐free compared with 7 of 17 Group I and II patients treated between 1970 and 1979. Three of five patients with disseminated tumors (Groups III and IV) are alive disease‐free compared with none in the previous series. Although the period of follow‐up is relatively short (median, 32 months), the overall survival of patients with medulloblastoma seems to be improved with additional radiation to the region of the cribriform plate. No side effects attributable to this modification were observed. In the opinion of the authors, this modification should be used routinely in patients with medulloblastoma.

Shielding in whole brain irradiation in the multileaf collimator era: Dosimetric evaluation of coverage using SFOP guidelines against in-house guidelines

“…[1,5,15] In medulloblastoma irrespective of the risk group cranio-spinal irradiation (CSI) with or without chemotherapy is the standard of treatment in postoperative setting. [3,4,[6][7][8][9][10]13,[16][17][18] In such situations, the use of a proper technique for the adequate coverage of PTV is of prime importance.…”

“…In medulloblastoma and ALL, nearly 15-20% of recurrences occur at this site which is attributed to overzealous shielding. [6][7][8][9][10][11][12][13] This emphasizes the importance of a proper technique for designing the shield in cranial radiation. There are various techniques reported in the literature of designing the shield.…”

Anaesthesia for radiation therapy – Gliwice experience

“…Sophisticated techniques of irradiation and tumor location reduce normal tissue margins to a minimum but also require almost ideal patient immobilization and significantly prolong the irradiation time [4]. The potential consequences of inadequate immobilization have been reported in the literature [5].…”

Sedation and Anesthesia Options for Pediatric Patients in the Radiation Oncology Suite

“…These casts make certain that the child will not move during the treatment sessions, ensuring that the radiation is directed at its target and not at normal surrounding tissue. Inadequate immobilization can result in treatment failure [7, 8] as well as damage to normal tissue [9]. …”