Late effects of craniospinal irradiation for medulloblastomas in paediatric patients.

Neuro-Chirurgie
V Bernier, O Klein

Abstract

Along with surgery, radiation therapy (RT) remains an essential option to cure patients suffering from medulloblastoma. However, its long-term adverse effects, particularly due to craniospinal irradiation (CSI), which is necessary to eradicate microscopic spread, are a limiting factor. The most frequent sequelae involve neurocognitive and endocrine impairment, which occurs in nearly all patients. Recent progress achieved through genetic and molecular biology offers the possibility to better stratify patients according to risk factors such as age, post-resection tumour residue and metastasis. Thus, new therapeutic studies assess the possibility to reduce radiation dose and/or radiation field size for patients with the most favourable prognosis. New radiotherapy techniques are also used such as Intensity-Modulated Radiotherapy (IMRT), tomotherapy and proton therapy, which aim at reducing the dose delivered to normal tissue. Conventional photon-based therapy has a relatively high exit dose in contrast with proton therapy which causes less damage to surrounding healthy tissue. It is noteworthy that each technique requires a long follow-up in order to prove that late effects could be reduced without compromising survival rates. Dosi...Continue Reading

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Citations

Nov 7, 2019·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Kim PhippsRichard Hayward
Nov 24, 2020·Pediatric Blood & Cancer·Wen Shen LooiJulie A Bradley
Nov 23, 2021·International Journal of Radiation Oncology, Biology, Physics·Michael ConnorIain MacEwan

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