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Radiotherapy Advances in Paediatric Medulloblastoma Treatment

L Padovani1, G Horan2, T Ajithkumar2

  • 1Aix-Marseille University, Oncology Radiotherapy Department, CRCM Inserm, UMR1068, CNRS UMR7258, AMU UM105, Genome Instability and Carcinogenesis, Assistance Publique des Hôpitaux de Marseille, Marseille, France.

Clinical Oncology (Royal College of Radiologists (Great Britain))
|January 19, 2019
PubMed

Insights

Pediatric medulloblastoma treatment relies on radiotherapy, achieving high survival rates. Research focuses on reducing side effects in standard-risk cases and improving outcomes in high-risk cases through advanced techniques and therapies.

Area of Science:

  • Pediatric Oncology
  • Radiation Oncology
  • Neuro-oncology

Background:

  • Radiotherapy is crucial for treating pediatric medulloblastoma, forming the cornerstone of curative care.
  • Modern multidisciplinary approaches yield high long-term survival rates: over 80% for standard-risk and up to 70% for high-risk medulloblastoma.
  • Ongoing research aims to optimize treatment strategies for different risk groups.

Purpose of the Study:

  • To review the role of radiotherapy in medulloblastoma management.
  • To discuss current research directions for standard-risk and high-risk medulloblastoma.
  • To highlight technological advancements and re-irradiation possibilities.

Main Methods:

  • Review of current radiotherapy practices and clinical trials in pediatric medulloblastoma.
  • Discussion of risk-adapted radiotherapy, dose-intensified chemotherapy, and hyperfractionated regimens.
  • Exploration of advanced radiotherapy technologies and re-irradiation strategies.

Main Results:

  • Current radiotherapy protocols lead to high survival rates in both standard-risk and high-risk pediatric medulloblastoma.
  • Risk-adapted radiotherapy is being evaluated to minimize long-term side effects in standard-risk patients.
  • Dose-intensification of chemotherapy and hyperfractionated radiotherapy are investigated for high-risk medulloblastoma.

Conclusions:

  • Advanced radiotherapy techniques like tomotherapy, VMAT, and proton therapy offer potential to reduce treatment toxicities.
  • Re-irradiation is a viable option for select pediatric medulloblastoma patients with recurrent disease.
  • Continued research and technological innovation are vital for improving outcomes and reducing sequelae in pediatric medulloblastoma survivors.

Keywords:
Childrenmedulloblastomaradiotherapy

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