gasillogic.blogg.se - Qarc medulloblastoma

#QARC MEDULLOBLASTOMA SKIN#
#QARC MEDULLOBLASTOMA TRIAL#

Young children (3-7 years) were also randomly assigned to receive standard-dose CSI (SDCSI 23.4 Gy) or low-dose CSI (LDCSI 18 Gy). METHODS ACNS0331 ( identifier: NCT00085735) randomly assigned patients age 3-21 years with average-risk MB to receive posterior fossa radiation therapy (PFRT) or involved field radiation therapy (IFRT) following CSI. Efforts to mitigate these effects include deintensification of craniospinal irradiation (CSI) dose and volume.

An involved field to boost the tumor bed may be as effective as, and less toxic than, boosting the whole PF.PURPOSE Children with average-risk medulloblastoma (MB) experience survival rates of ≥ 80% at the expense of adverse consequences of treatment.

A «trend» for a better EFS and OS was observed among patients with lesser number of major deviations (i.e., 0-1).

Underdosage or treatment volume misses did not correlate with a worse EFS or OS.

Major treatment deviations were observed in 57% of fully evaluable patients.

Results: EFS & OS by site and deviation status

Fully evaluable:đ60 patients # deviations # patients 0 69 1 50 2 31 3 09 4 01.

5-year EFS & OS according to treatment correctness.

WBI: 0-4 mm, minor 51 & >58 days were conpensated with 1 or 2 additional fractions to the PF.

Tumor: distance between the boost field limits & the tumor borders as seen in the pre-op brain MRI/CT.

PF: distance between the boost field limits & the tentorium, C1-C2, post clinoids, post convexity.

Spine: distance between the end of the inf field limit & the end of the dural sac (MRI).

WBI: distance between the inf field limit & both the cribiform plate & floor of the middle cranial fossa.

PF: tentorium+1 cm C1-C2 interspace post clinoids post convexity.

Spine: inf border 2 cm below the subdural space.

WBI:inf border 0.5 cm below base of skull.

224high-risk stagepatients randomized : - Post-op residual tumor: >1.5 cm3 - T3b, T4 - M+ (1-3).

Randomize between: -Arm 1:CDDP+VP16- CSI- vcr+cycloph.

#QARC MEDULLOBLASTOMA TRIAL#

Purpose To evaluate the potential influence of the quality of RT on event-free (EFS) & overall survival (OS) in a group of high-riskpediatric medulloblastoma patients treatedin POG Trial 9031

Radiotherapy in pediatric medulloblastoma: quality assessment of POG Trial 9031 R.Miralbell QARC & Swiss POG Geneva, CH Dose at the spinal cord (depth and SSD vary). Fields match on the anterior edge of the spinal cordįinal dosimetry in a sagittal slice passing through the spinal cord. Moving junction between the two spinal fields. We use asymetric fields (one isocenter for the same region). Moving junctions between the brain fields and the spinal field. Without with Effect of the table rotation on the field ’s matching Junction (brain-spine) in a sagittal slice

#QARC MEDULLOBLASTOMA SKIN#

Mark on the skin shifts Set-up of the spinal field Set-up of the left lateral brain field with the different structures. Mark on the skin for the spine field Lateral mark Patient set-up Virtual simulation for cranio-spinal irradiation of medulloblastoma.Clara Jargy, Philippe Nouet, Raymond Miralbell.Radiation Oncology, Geneva University Hospital MiralbellHôpitaux Universitaires, GenèveĬlinical features favorably influencing survival in pediatric medulloblastoma: univariate analysis Author Period #ptsGenderĚge T-stageM-stage Hershatter et alđ940-83đ27 - >T2 NE Tait et al 1975-79Ē86 female -Ĕ years - M0 Jenkin et alđ977-87ė2 female -ē years - M0 Miralbell et alđ972-91Ę6 female - M0Ĭlinical features favorably influencing survival in pediatric medulloblastoma: multivariate analysis Author Period #ptsGenderĚge T-stageM-stage Hershatter et alđ940-83đ27 - >T2 NE Evans et alđ975-81Ē33 - >4 years - M0 Jenkin et alđ977-87ė2 - Wara et alđ970-95đ09 female - M0 Miralbell et alđ972-91Ę6 female - M0