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[Radiotherapy of cerebellar medulloblastoma in children]
O I Shcherbenko1, N I Zelinskaia, R A Parkhomenko
1Russian Center for Roentgeno-Radiology Research, Ministry of Health of the RF, Moscow.
Insights
This study on pediatric brain tumors found cerebral medulloblastoma in 34% of cases. Radical surgery was the key factor for survival in children with brain tumors.
Area of Science:
- Pediatric Oncology
- Radiation Oncology
- Neuro-oncology
Context:
- Retrospective analysis of 108 children (aged 3-15) treated for brain tumors between 1991-1997.
- Cerebral medulloblastoma identified in 37% of cases, treated with surgery, polychemotherapy, and radiotherapy.
Purpose:
- To evaluate treatment outcomes and prognostic factors for pediatric brain tumors, specifically cerebral medulloblastoma.
- To assess the efficacy of radiotherapy and polychemotherapy in conjunction with surgical interventions.
Summary:
- 37 out of 108 children had cerebral medulloblastoma, receiving 4-12 cycles of polychemotherapy post-surgery.
- Radiotherapy involved 30-35 Gy to the brain and spinal cord, with a boost of 50-55 Gy to the posterior cranial fossa.
- Survival rates showed 19 of 32 follow-up patients survived (average 33 months), while 13 died (average 21 months).
Impact:
- Local tumor progression and leptomeningeal dissemination were primary causes of treatment failure.
- Radical extent of surgical tumor excision emerged as the most significant prognostic factor for survival.
- Demyelination was noted as a complication in one patient following repeated radiation exposure.
Abstract:
Out of 108 children with brain tumors, aged 3-15, receiving radiotherapy in 191-1997, cerebral medulloblastoma was identified in 37 (34%). After total or subtotal excision of tumor, the latter were given 4-12 cycles of polychemotherapy. The brain and spinal marrow was exposed to 30-35 Gy followed by aiming 50-55 Gy irradiation of posterior cranial fossa. Three patients received radiation for recurrent tumor. One patient suffered demyelination as complication after repeated exposure. Out of 32 follow-up patients, 19 have survived an average of 33 months while 13 died having survived an average of 21 months. The main causes of failed therapy proved local progression of tumor and dissemination via liquor. Radical extent of surgery was used as the main prognostic factor.