Repeated Craniospinal Irradiation in Patients With Recurrence of Medulloblastoma

Abstract

Medulloblastoma is the most common malignant CNS tumor in children, which occurs in the posterior cranial fossa and has a high risk of metastasis along the cerebrospinal fluid. A modern approach to treatment for patients older than 3 years includes the removal of the tumor with mandatory postoperative craniospinal irradiation with “boost” on the postoperative bed, followed by chemotherapy with platinum-containing drugs, which allows reaching a level of 80% for 5-year progression-free survival. In case of recurrence of the disease, the prognosis remains unfavorable. With multiple recurrence of supra-sub tentorial localization, it may be necessary to conduct repeated craniospinal irradiation. In this work, we considered the possibility of repeated craniospinal irradiation, which in some cases, subject to the use of modern radiation therapy techniques with a high degree of conformity, can be an effective form of treatment for multiple relapses of meduloblastoma with an acceptable level of toxicity.