Reirradiation for recurrent medulloblastoma.

摘要: BACKGROUND: Previously irradiated recurrent medulloblastoma (MB) is a highly lethal disease. Reirradiation often not considered secondary to its potential toxicity and uncertain efficacy. Analysis of retreatment could help identify the feasibility role reirradiation for MB. METHODS: Thirteen patients who underwent at least 1 course authors’ institution as component management after recurrence were identified, their medical records analyzed. RESULTS: At first diagnosis, all surgical resection radiation, with 69% receiving chemotherapy. Median time initial failure was 50 months (range, 14-103 months). subsite breakdown follows: posterior fossa, 46%; supratentorial/whole brain, 31%; spine, 23%; craniospinal, 8%. cumulative dose 84 grays 65-98.4 grays). Of 11 completing full reirradiation, there 6 failures, 3 in field. Kaplan-Meier estimates progression-free overall survival since 48% 65%, respectively 5 years. without gross disease 83% evidence last follow-up. With median follow-up 30 months, well tolerated, only case asymptomatic, in-field radiation necrosis. CONCLUSIONS: The results this series are promising, but must be interpreted caution given limitations. provided most benefit no re-resection, Important considerations development include duration between courses patient age. Further study part trimodality therapy warranted. Cancer 2011;117:4977–82. V C 2011 American Society.