Protracted radiotherapy treatment duration in medulloblastoma

Arnold C Paulino; B-Chen Wen; Nina A Mayr; Raymond Tannous; Thomas W Loew; Frederick D Goldman; Sanford L Meeks; Timothy C Ryken; John M Buatti

doi:10.1097/00000421-200302000-00012

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Protracted radiotherapy treatment duration in medulloblastoma

Journal article

Peer reviewed

Protracted radiotherapy treatment duration in medulloblastoma

Arnold C Paulino, B-Chen Wen, Nina A Mayr, Raymond Tannous, Thomas W Loew, Frederick D Goldman, Sanford L Meeks, Timothy C Ryken and John M Buatti

American journal of clinical oncology, Vol.26(1), pp.55-59

02/2003

DOI: 10.1097/00000421-200302000-00012

PMID: 12576926

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Abstract

From 1970 to 1997, 63 patients with medulloblastoma were treated with craniospinal irradiation followed by a posterior fossa boost. There were 38 males and 25 females with a median age of 9 years (range, 8 months to 53 years). Stage was T1-T3a in 50 (79%) and M0 in 38 patients (60%) according to the Chang staging system. Gross total resection of the primary tumor was achieved in 33 (52%) and median posterior fossa dose was 54 Gy, with 55 (87%) receiving > or =50 Gy. Median radiotherapy treatment duration was 49 days (range, 30-104 days) with 35 patients (56%) completing radiotherapy in <50 days. The most common reasons for a protracted radiotherapy treatment duration > or =50 days were hematologic toxicity (46%) and use of <1.6 Gy fraction size per day (29%). Chemotherapy was used in 22 (35%). Median follow-up time was 10.8 years (range, 2-28.5 years). The 5- and 10-year freedom from progression rates were 58% +/- 13% and 50% +/- 13%, respectively, whereas the 5- and 10-year posterior fossa control rates were 61% +/- 12% and 54% +/- 13%, respectively. On multivariate analysis, age > or =3 years, M0 status, > or =50 Gy PFB dose, radiotherapy treatment duration <50 days, and use of chemotherapy correlated with better freedom from progression and posterior fossa control rates. The 5- and 10-year freedom from progression rates were 67% +/- 15% and 64% +/- 16%, respectively, for patients with radiotherapy treatment duration <50 days and were 42% +/- 20% and 29% +/- 18%, respectively, for duration > or =50 days ( p= 0.0026, log-rank test). The 5- and 10-year posterior fossa control rates were 70% +/- 15% and 70% +/- 15%, respectively, for radiotherapy treatment duration <50 days and 46% +/- 20% and 33% +/- 19%, respectively, for duration > or =50 days ( p= 0.0037, log-rank test). In addition to age > or =3 years, M0 stage, use of adjuvant chemotherapy, and posterior fossa dose > or =50 Gy, our findings also reveal that radiotherapy treatment duration <50 days has a favorable prognostic outcome in patients with medulloblastoma.

Radiotherapy Dosage

Cerebellar Neoplasms - drug therapy

Humans

Middle Aged

Child, Preschool

Cranial Fossa, Posterior

Infant

Male

Treatment Outcome

Combined Modality Therapy

Cranial Irradiation

Medulloblastoma - radiotherapy

Adolescent

Survival Analysis

Adult

Female

Medulloblastoma - surgery

Cerebellar Neoplasms - surgery

Medulloblastoma - drug therapy

Cerebellar Neoplasms - radiotherapy

Child

Details

Title: Subtitle: Protracted radiotherapy treatment duration in medulloblastoma
Creators: Arnold C Paulino - Department of Radiation Oncology, the University of Iowa, College of Medicine and Children's Hospital of Iowa, Iowa City, Iowa, USA. arnold@radonc.emory.org
B-Chen Wen
Nina A Mayr
Raymond Tannous
Thomas W Loew
Frederick D Goldman
Sanford L Meeks
Timothy C Ryken
John M Buatti
Resource Type: Journal article
Publication Details: American journal of clinical oncology, Vol.26(1), pp.55-59
Publisher: United States
DOI: 10.1097/00000421-200302000-00012
PMID: 12576926
ISSN: 0277-3732
eISSN: 1537-453X
Language: English
Date published: 02/2003
Academic Unit: Stead Family Department of Pediatrics; Radiation Oncology; Neurosurgery; Otolaryngology
Record Identifier: 9984040246602771

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