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Is there an increased risk of spinal relapse in standard-risk medulloblastoma/primitive neuroectodermal tumor patients who receive only a reduced dose of craniospinal radiotherapy?

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Abstract

Purpose

Medulloblastoma (MBL) is the most common pediatric brain malignancy. Postoperative radiotherapy to the entire craniospinal axis is the standard-of-care but has linked to long-term morbidity. In this study, we analyzed the implication of reduced dose craniospinal radiotherapy (RT) for survival and pattern of relapse in MBL patients.

Material and methods

The clinical characteristics of 32 consecutively diagnosed medulloblastoma/primitive neuroectodermal tumor patients were analyzed. After surgical resection, a dose of 23.4 Gy of spinal RT with a posterior fossa boost of 30.6 Gy was prescribed to standard-risk patients, whereas high-risk patients received 36 Gy spinal RT with additional boosts to the posterior fossa up to 54 Gy. Then, both groups received the same chemotherapy protocol.

Results

Five-year OS for standard and high-risk patients was 94 and 50%, respectively. When analyzing prognostic factors, postoperative tumor size is the most important one which affects the OS. Ten patients relapsed during follow-up, and there was no isolated spinal relapse in either group.

Conclusion

The risk of isolated spinal relapse does not increase with reduced-dose craniospinal RT, since there is no isolated relapse in either the standard or high-risk groups of patients.

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Author information

Authors and Affiliations

  1. Faculty of Medicine, Department of Pediatric Oncology, Ege University, İzmir, Turkey

    Akıncı Burcu, Çetingül Nazan, Kantar Mehmet, Aksoylar Serap & Kansoy Savaş

  2. Faculty of Medicine, Department of Pediatrics, Ege University, İzmir, Turkey

    Özdemir Özgür

  3. Faculty of Medicine, Department of Radiation Oncology, Ege University, İzmir, Turkey

    Kamer Serra & Anacak Yavuz

  4. Department of Pediatric Oncology, Dr. Behçet Uz State Children Hospital, İzmir, Turkey

    Demirağ Bengü & Vergin Canan

  5. Department Pediatric Oncology, Tepecik Training and Research Hospital, İzmir, Turkey

    Öniz Haldun

  6. Faculty of Medicine, Department of Neurosurgery, Ege University, İzmir, Turkey

    Turhan Tuncer

  7. Faculty of Medicine, Department of Pathology, Ege University, İzmir, Turkey

    Akalın Taner & Ertan Yeşim

  8. Faculty of Medicine, Department of Radiology, Ege University, İzmir, Turkey

    Kitiş Ömer

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  1. Akıncı Burcu
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Correspondence to Akıncı Burcu.

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Burcu, A., Nazan, Ç., Özgür, Ö. et al. Is there an increased risk of spinal relapse in standard-risk medulloblastoma/primitive neuroectodermal tumor patients who receive only a reduced dose of craniospinal radiotherapy?. Childs Nerv Syst 34, 1657–1662 (2018). https://doi.org/10.1007/s00381-018-3842-6

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  • DOI: https://doi.org/10.1007/s00381-018-3842-6

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