+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Reducing toxicity from craniospinal irradiation: using proton beams to treat medulloblastoma in young children



Reducing toxicity from craniospinal irradiation: using proton beams to treat medulloblastoma in young children



Cancer Journal 10(6): 386-390



We report on a radiation treatment technique that has reduced the dose to critical normal structures in children with medulloblastoma. Three children between the ages of 3 and 4 with stage M2 or M3 medulloblastoma were treated between 2001 and 2003 with craniospinal irradiation using protons. Patients received 36 cobalt gray equivalent to the craniospinal axis, then 18 cobalt gray equivalent to the posterior fossa. The cranium was treated with opposed lateral fields. The spine was treated with three matched posteroanterior fields, with the beam stopping just beyond the thecal sac. The posterior fossa was then treated with alternating posteroanterior, right posterior oblique, and left posterior oblique fields, with the beam stopping just proximal to the cochlea. The use of general anesthesia and pre-porting with diagnostic-quality x-rays allowed precise patient positioning. Craniospinal irradiation delivered via conformal proton irradiation substantially reduced the dose to the cochlea and vertebral bodies and virtually eliminated the exit dose through thorax, abdomen, and pelvis. Despite concurrent chemotherapy, a clinically significant lymphocyte count reduction was not seen. Patients tolerated treatment well; acute side effects (e.g., nausea, decreased appetite, and odynophagia) were mild. All patients completed therapy without interruption. Our proton-beam technique for craniospinal irradiation of pediatric medulloblastoma has successfully reduced normal-tissue doses and acute treatment-related sequelae. This technique may be especially advantageous in children with a history of myelosuppression, who might not other wise tolerate irradiation.

Please choose payment method:






(PDF emailed within 1 workday: $29.90)

Accession: 050141456

Download citation: RISBibTeXText

PMID: 15701271


Related references

Proton beam craniospinal irradiation reduces acute toxicity for adults with medulloblastoma. International Journal of Radiation Oncology Biology Physics 86(2): 277-284, 2013

Reduced acute toxicity for adults with medulloblastoma treated with proton beam craniospinal irradiation. Strahlentherapie und Onkologie 190(1): 111-112, 2014

A review of dosimetric and toxicity modeling of proton versus photon craniospinal irradiation for pediatrics medulloblastoma. Acta Oncologica 56(8): 1031-1042, 2017

Effects of vertebral-body-sparing proton craniospinal irradiation on the spine of young pediatric patients with medulloblastoma. Advances in Radiation Oncology 2(2): 220-227, 2017

A pilot study of preirradiation chemotherapy and 1800 cGy craniospinal irradiation in young children with medulloblastoma. International Journal of Radiation Oncology, Biology, Physics 60(2): 531-536, 2004

Medulloblastoma in very young children: outcome of definitive craniospinal irradiation following incomplete response to chemotherapy. Strahlentherapie und Onkologie 171(4): 247-248, 1995

Medulloblastoma in very young children: outcome of definitive craniospinal irradiation following incomplete response to chemotherapy. Journal of Clinical Oncology 12(6): 1212-1216, 1994

Acute toxicity profile of craniospinal irradiation with intensity-modulated radiation therapy in children with medulloblastoma: A prospective analysis. Radiation Oncology 10: 241, 2015

Survival of very young children with medulloblastoma (primitive neuroectodermal tumor of the posterior fossa) treated with craniospinal irradiation. International Journal of Radiation Oncology Biology Physics 42(5): 959-967, 1998

Hypothyroidism after craniospinal irradiation with proton or photon therapy in patients with medulloblastoma. Pediatric Hematology and Oncology 35(4): 257-267, 2018

Outcome and toxicity using helical tomotherapy for craniospinal irradiation in pediatric medulloblastoma. Clinical and Translational Oncology 16(1): 96-101, 2014

Comparison of risk of radiogenic second cancer following photon and proton craniospinal irradiation for a pediatric medulloblastoma patient. Physics in Medicine and Biology 58(4): 807-823, 2013

Craniospinal irradiation techniques: a dosimetric comparison of proton beams with standard and advanced photon radiotherapy. International Journal of Radiation Oncology Biology Physics 81(3): 637-646, 2011

Stray radiation dose and second cancer risk for a pediatric patient receiving craniospinal irradiation with proton beams. Physics in Medicine and Biology 54(8): 2259-2275, 2009

Reducing Toxicity from Craniospinal Irradiation. The Cancer Journal 10(6): 386-390, 2004