Related Experiment Video
Updated: Jan 20, 2026
Author Spotlight: Tracing the Ferroptotic Signatures and Cell Death Dynamics in Medulloblastoma for Advanced Therapeutics
Published on: March 15, 2024
Re-irradiation for children with recurrent medulloblastoma in Toronto, Canada: a 20-year experience
Derek S Tsang1,2, Nasim Sarhan3, Vijay Ramaswamy4
1Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, 610 University Avenue, Toronto, ON, M5G 2M9, Canada. derek.tsang@rmp.uhn.ca.
Purpose:
Children with recurrent medulloblastoma have a poor prognosis. Re-irradiation is an option for some patients, but has not been well-studied in the era of molecular characterization for pediatric medulloblastoma.
Methods:
This was a retrospective cohort study of 14 children age 18 years and younger at initial diagnosis with recurrent medulloblastoma, who received two or more courses of radiation therapy (RT). Molecular subgrouping was performed using nanoString and was available for nine patients. The primary study endpoint was overall survival.
Results:
Re-irradiation (RT2) was directed at the supratentorial brain in six patients, infratentorial brain in one patient, and spine in seven patients. In addition, six patients received stem cell transplant as part of salvage therapy. Median OS for all patients was 12.4 months. One patient with recurrent Wnt-activated medulloblastoma remains alive with 154 months' survival; median survival was not reached for four patients with Group 4 disease, while three with Shh-activated disease had median survival of 2.2 months. A single patient with Group 3 disease died 4.3 months after RT2. Patients treated with RT2 to the spine for diffuse disease had poorer OS (p = 0.02), as compared to focal RT2 for intracranial recurrence. Distant failure, outside RT2 volumes, was the predominant pattern of recurrence after RT2.
Conclusions:
Re-irradiation for recurrent pediatric medulloblastoma can offer some patients disease control, particularly those with focally recurrent disease in the brain. Prospective studies are needed to confirm subgroups of patients who may benefit most from RT2.
Insights
Re-irradiation for recurrent pediatric medulloblastoma can control disease in some children, especially those with focal recurrence. Further studies are needed to identify specific patient groups who benefit most from this treatment.
Area of Science:
- Pediatric Oncology
- Radiation Oncology
- Neuro-oncology
Background:
- Recurrent medulloblastoma in children has a poor prognosis.
- Re-irradiation (RT2) is a potential salvage option but lacks extensive study in the era of molecular subtyping.
- Molecular characterization is crucial for understanding medulloblastoma behavior and treatment response.
Purpose of the Study:
- To evaluate the efficacy and outcomes of re-irradiation in pediatric patients with recurrent medulloblastoma.
- To explore the impact of molecular subgroups on survival after re-irradiation.
- To identify patterns of failure and prognostic factors in this patient population.
Main Methods:
- Retrospective cohort study of 14 pediatric patients (≤18 years) with recurrent medulloblastoma who received ≥2 courses of radiation therapy.
- Molecular subgrouping performed using nanoString for nine patients.
- Primary endpoint was overall survival (OS); secondary analyses included patterns of failure and prognostic factors.
Main Results:
- Median OS for all patients was 12.4 months.
- Patients with Wnt-activated medulloblastoma showed prolonged survival (154+ months).
- Group 4 disease had not reached median survival, while Shh-activated disease had a median survival of 2.2 months.
- Spinal re-irradiation for diffuse disease was associated with poorer OS (p=0.02) compared to focal intracranial recurrence.
- Distant failure outside RT2 volumes was the predominant recurrence pattern.
Conclusions:
- Re-irradiation can provide disease control for select pediatric medulloblastoma patients with recurrent disease.
- Focal intracranial re-irradiation may be more beneficial than spinal re-irradiation for diffuse recurrence.
- Prospective studies are essential to confirm which molecular subgroups and clinical presentations benefit most from re-irradiation.
Related Concept Videos
04:01Revealing the Ferroptotic Phenotype of Medulloblastoma
06:40Automated Delivery of Microfabricated Targets for Intense Laser Irradiation Experiments
12:40Exploring Cognitive Functions in Babies, Children & Adults with Near Infrared Spectroscopy
09:49Growth and Characterization of Irradiated Organoids from Mammary Glands
06:32Isolation, Enrichment, and Maintenance of Medulloblastoma Stem Cells
05:10Intracranial Orthotopic Allografting of Medulloblastoma Cells in Immunocompromised Mice