Conformal radiotherapy, reduced boost volume, hyperfractionated radiotherapy, and online quality control in standard-risk medulloblastoma without chemotherapy: results of the French M-SFOP 98 protocol

Conformal radiotherapy, reduced boost volume, hyperfractionated radiotherapy, and online quality control in standard-risk medulloblastoma without chemotherapy: results of the French M-SFOP 98 protocol

Between December 1998 and October 2001, patients <19 years old were treated for standard-risk medulloblastoma according to the Medulloblastome-Société Française d'Oncologie Pédiatrique 1998 (M-SFOP 98) protocol. Patients received hyperfractionated radiotherapy (36 Gy in 36 fractions) to the...

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Bibliographic Details
Published in:International journal of radiation oncology, biology, physics Vol. 63; no. 3; p. 711
Main Authors: Carrie, Christian, Muracciole, Xavier, Gomez, Frédéric, Habrand, Jean-Louis, Benhassel, Mohamed, Mege, Martine, Mahé, Marc, Quetin, Philippe, Maire, Jean Philippe, Soum, Françoise, Baron, Marie Helene, Clavere, Pierre, Chapet, Sophie, Gaci, Zineb, Kolodie, Helene, Maingon, Philippe, Vie, Bernard, Bernier, Valérie, Alapetite, Claire, Hoffstetter, Sylvette, Grill, Jacques, Lafay, Frédéric
Format: Journal Article
Language:English
Published: United States 01-11-2005
Subjects:
Adolescent
Cerebellar Neoplasms - radiotherapy
Child
Cognition
Dose Fractionation
Feasibility Studies
France
Humans
Medulloblastoma - radiotherapy
Neoplasm Recurrence, Local
Pilot Projects
Quality Control
Radiotherapy, Conformal - methods
Survival Analysis
Treatment Outcome
France
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Summary:Between December 1998 and October 2001, patients <19 years old were treated for standard-risk medulloblastoma according to the Medulloblastome-Société Française d'Oncologie Pédiatrique 1998 (M-SFOP 98) protocol. Patients received hyperfractionated radiotherapy (36 Gy in 36 fractions) to the craniospinal axis, a boost with conformal therapy restricted to the tumor bed (to a total dose of 68 Gy in 68 fractions), and no chemotherapy. Records of craniospinal irradiation were reviewed before treatment start. A total of 48 patients were considered assessable. With a median follow-up of 45.7 months, the overall survival and progression-free survival rate at 3 years was 89% and 81%, respectively. Fourteen major deviations were detected and eight were corrected. No relapses occurred in the frontal region and none occurred in the posterior fossa outside the boost volume. Nine patients were available for volume calculation without reduction of the volume irradiated. We observed a reduction in the subtentorial volume irradiated to >60 Gy, but a slight increase in the volume irradiated to 40 Gy. No decrease in intelligence was observed in the 22 children tested during the first 2 years. This hyperfractionated radiotherapy protocol with a reduced boost volume and without chemotherapy was not associated with early relapses in children. Moreover, intellectual function seemed to be preserved. These results are promising.
ISSN:0360-3016
DOI:10.1016/j.ijrobp.2005.03.031