Metachronous medulloblastoma and glioblastoma: Implications for clinical and technical aspects of re-irradiation
| Autor: | Chi Lin, Rajesh R. Kulkarni, Abhijeet R. Bhirud, Rodney D. McComb, Vivek Verma, Nathan R. Bennion |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Medulloblastoma
Re-Irradiation medicine.medical_specialty Temozolomide business.industry medicine.medical_treatment Planning target volume Case Report Subtotal Resection medicine.disease Surgery Radiation therapy 03 medical and health sciences 0302 clinical medicine Oncology 030220 oncology & carcinogenesis medicine Radiology Nuclear Medicine and imaging Brainstem Radiology business 030217 neurology & neurosurgery medicine.drug Glioblastoma |
| Zdroj: | Reports of Practical Oncology & Radiotherapy. 21:84-89 |
| ISSN: | 1507-1367 |
| DOI: | 10.1016/j.rpor.2015.10.002 |
| Popis: | A seven-year-old male underwent surgical resection and chemoradiation for average risk medulloblastoma; twelve years later, the presence of a necrotic and infiltrative mass in the same area and invading the brainstem prompted a subtotal resection. Pathology was indicative of glioblastoma. He was then treated with concurrent temozolomide and using biologically effective dose calculations for gross residual tumor tissue in the brainstem as well as brainstem tolerance, a radiotherapy dose of 3750 cGy was chosen, fractionated in twice-daily fractions of 125 cGy each. The gross tumor volume was expanded with a 5 mm margin to the planning target volume, which was also judiciously subtracted from the normal brainstem. He completed his radiotherapy course with subsequent imaging free of residual tumor and continued adjuvant temozolomide and remains under follow-up surveillance. This case underscores the rarity of metachronous medulloblastoma and glioblastoma, of which only five known cases heretofore have been described. We discuss the technicalities of radiotherapy planning in this patient, including common hurdles for radiation oncologists in similar patients. |
| Databáze: | OpenAIRE |
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