Reirradiation of relapsed brain tumors in children

Chojnacka, Marzanna; Skowrońska‐Gardas, Anna; Pędziwiatr, Katarzyna; Morawska-Kaczyńska, M.; Perek, M.; Perek, Danuta

doi:10.1016/j.rpor.2011.10.004

Cited by 17 publications

(8 citation statements)

References 18 publications

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“…This is consistent with a report that specifically assessed reirradiation of eight pediatric brain tumors with 16-month median followup. 19 The median cumulative BED 2 was 144 Gy, with a range of 126-181 Gy. Radiotherapy was tolerated by all eight patients without significant re-irradiation complications, though the median survival is too low in these patients to assess late complications.…”

Section: Discussion/conclusionmentioning

confidence: 97%

Metachronous medulloblastoma and glioblastoma: Implications for clinical and technical aspects of re-irradiation

Verma

Kulkarni

Bhirud

et al. 2016

Reports of Practical Oncology & Radiotherapy

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Glioblastoma Re-irradiation Brainstem tolerance Toxicity a b s t r a c tA seven-year-old male underwent surgical resection and chemoradiation for average risk medulloblastoma; twelve years later, the presence of a necrotic and infiltrative mass in the same area and invading the brainstem prompted a subtotal resection. Pathology was indicative of glioblastoma. He was then treated with concurrent temozolomide and using biologically effective dose calculations for gross residual tumor tissue in the brainstem as well as brainstem tolerance, a radiotherapy dose of 3750 cGy was chosen, fractionated in twice-daily fractions of 125 cGy each. The gross tumor volume was expanded with a 5 mm margin to the planning target volume, which was also judiciously subtracted from the normal brainstem. He completed his radiotherapy course with subsequent imaging free of residual tumor and continued adjuvant temozolomide and remains under followup surveillance. This case underscores the rarity of metachronous medulloblastoma and glioblastoma, of which only five known cases heretofore have been described. We discuss the technicalities of radiotherapy planning in this patient, including common hurdles for radiation oncologists in similar patients. BackgroundMetachronous brain tumors are defined as the development of at least two histologically distinct primary intracranial neoplasms, not related to local recurrence of the initial tumor. novo tumor. 1 Sometimes, the development of a second primary brain tumor is a result of previous radiation, especially in pediatric patients. 2,3 The presence of certain risk factors, such as familial cancer syndromes, may increase the chance of developing secondary neoplasms after radiotherapy. 4 While many radiation-induced intracranial neoplasms have been reported within fifteen years of radiotherapy, 2,3 http://dx

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Section: Discussion/conclusionmentioning

confidence: 97%

Metachronous medulloblastoma and glioblastoma: Implications for clinical and technical aspects of re-irradiation

Verma

Kulkarni

Bhirud

et al. 2016

Reports of Practical Oncology & Radiotherapy

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“…External-beam radiotherapy can be offered either in a definitive setting or after maximal safe resection, despite most of the literature reports data concerning exclusive intent. To date, almost 300 cases of re-irradiation after craniospinal radiotherapy are reported in the literature (Table I), but it is hard to compare these data due to the heterogeneity of the in vivo 34: 1283-1288 (2020) cohorts; furthermore, different RT schedules are used with or without chemotherapy, and only a few reports are available on the use of stereotactic radiotherapy (17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32).…”

Section: Discussionmentioning

confidence: 99%

Salvage Re-irradiation Options in Adult Medulloblastoma: A Case Report and Review of the Literature

Cuccia

Mortellaro²,

Ognibene³

et al. 2020

In Vivo

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Background/Aim: Medulloblastoma is a rare tumor of adult age, while it occurs more frequently in children. Given the rarity, there is a lack of evidence for the treatment of recurrent disease. Few data are available about salvage reirradiation collecting very heterogeneous series. Case Report: A 51-year-old male presented with headache, nausea, double vision, and gait disorders. A contrast-enhanced brain-MRI showed the presence of multifocal medulloblastoma. After surgery, adjuvant craniospinal radiotherapy was performed, chemotherapy was stopped due to toxicity. After 27 months, a new MRI and a Methionine-PET revealed a late pontocerebellar relapse; multidisciplinary board decided for a SBRT treatment. The second course of RT was well tolerated and 14 months later, the patient is alive in good general conditions, with no evidence of disease. Conclusion: Our experience supports the use of salvage stereotactic radiotherapy as a safe and effective treatment option. Medulloblastoma is one of the most common central nervous system tumors of childhood (1), while it has an extremely lower incidence in the adult age, particularly in >40 years patients (2). Furthermore, in older patients it may occur with unusual presentations, like multifocal disease, of which only six cases are described in the literature (3-8). Due to its rarity in the older 1283 This article is freely accessible online.

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“…On the other hand, HT spares the kidneys to a greater extent than 3DCRT, which is important to note as majority of CSI patients received or will receive nephrotoxic CTx. 31 Last but not least, the CSI is a challenge not only for medical staff but for the patients as well as the dose delivery per fraction can take more than 20 min plus additional time for positioning and set-up verification. 21 In this case, for most of the patients a supine position seems superior to prone, this constituting an additional argument for using tomotherapy for CSI.…”

Section: Discussionmentioning

confidence: 99%

Prospective study on dosimetric comparison of helical tomotherapy and 3DCRT for craniospinal irradiation – A single institution experience

Bandurska-Luque

Piotrowski

Skrobała

et al. 2015

Reports of Practical Oncology & Radiotherapy

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Reirradiation of relapsed brain tumors in children

Abstract: In the absence of other treatment possibilities, the fractionated reirradiation with highly conformal three-dimensional planning could be a therapeutic choice in case of recurrent brain tumors in children. The control of craniospinal dissemination remains to be the main problem.

Cited by 17 publications

References 18 publications

Metachronous medulloblastoma and glioblastoma: Implications for clinical and technical aspects of re-irradiation

Metachronous medulloblastoma and glioblastoma: Implications for clinical and technical aspects of re-irradiation

Salvage Re-irradiation Options in Adult Medulloblastoma: A Case Report and Review of the Literature

Prospective study on dosimetric comparison of helical tomotherapy and 3DCRT for craniospinal irradiation – A single institution experience

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