Craniospinal Irradiation in Children with Medulloblastoma in Supine Position: Long-Term Results

Czech version

Authors: P. Šlampa ¹; K. Zitterbart ²; L. Dušek ³; O. Magnová ²; H. Doleželová ¹; P. Čoupek ¹; P. Pospíšil ¹; Š. Sovadinová ¹; Z. Pavelka ²; J. Štěrba ²; M. Chrenko ¹; K. Miklóšová ¹
Authors‘ workplace: Odd. radiační onkologie, Masarykův onkologický ústav, Brno ¹; Klinika dětské onkologie, LF MU a FN Brno ²; Centrum informatiky a analýz, Masarykova univerzita, Brno ³
Published in: Cesk Slov Neurol N 2007; 70/103(3): 308-314
Category: Short Communication

Overview

Radiotherapy is an essential method of treatment for medulloblastoma, but the surgery is the primary treatment of choice in the disorder mentioned. In this study, a total number of 33 pediatric patients under 15 years (median age 8.7 years) were irradiated post-operatively within January 1997 and March 2005. All tumors were located infratentorially in the posterior fossa. Chemotherapy was administered in 26 patients (78 %). The patients with craniospinal irradiation were placed in supine position and fixed with a vacuum-form body immobilizer and a head mask. Irradiation was delivered using a planned dose 26–30 Gy with standard 1.3–1.8 Gy daily fractions for the craniospinal axis with photon beam (6 MV). The median overall survival for the whole group was 55.3 months. The median disease-free survival was 20.6 months, 8 patients (24 %) died. No statistical difference in survival rate between standard and high-risk patients was shown. No relationship was found between survival and age, sex or the tumor size. Endocrine deficits occurred in 30% (8 patients of the group were hypothyroid, growth retardation occurred in 7 patients). Our therapeutical results (those of overall and disease-free survival) and side-effects of the craniospinal axis irradiation technique in supine position are comparable with the treatment results and technique toxicity in prone position.

Key words:
medulloblastoma – radiotherapy – craniospinal irradiation

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