1. Home
  2. Vol 19, No 2 (2025)
  3. Banjarnahor

Craniospinal Irradiation in Adult Medulloblastoma: A Case Report and Analysis of Treatment Planning Comparing Volumetric Modulated Arc Therapy and Three-Dimensional Conformal Radiotherapy

Christine Tiarma Ully Banjarnahor, Andreas Nainggolan, Agustinus Darmadi Hariyanto

Abstract


Introduction: Adult medulloblastoma is a very uncommon case. Multimodal treatment, including surgery, radiation therapy, and chemotherapy, has led to an improvement not only in long-term survival but also in major-related toxicity.

Case Presentation: We report the case of a 24-year-old man with medulloblastoma who underwent surgery followed by volumetric modulated arc therapy (VMAT) craniospinal irradiation (CSI) three weeks after resection. The radiation dose was 36 Gy in 20 fractions to the craniospinal axis, with an 18 Gy boost dose in 10 fractions to the posterior fossa. Threedimensional conformal radiotherapy (3D-CRT) planning was done to compare the dosimetric results of VMAT and 3D-CRT.

Conclusion: The VMAT CSI technique delivers a better dose of homogeneity, conformity, and OARs-sparing than 3D-CRT


Keywords


adult medulloblastoma, craniospinal irradiation, three-dimensional conformal radiotherapy, volumetric modulated arc therapy

Full Text: View | Download

DOI: 10.33371/ijoc.v19i2.1231

Article Metrics

Abstract View: 443,
PDF Download: 126
             

References


Kristeva M, Suprun A, Ghaffar E, Wallis C. Adult Medulloblastoma: Occurrence of a Rare Event. Cureus. 2018 Jul 18;10(7):e3000.

Faried A, Pribadi M, Sumargo S, et al. Adult medulloblastoma: A rare case report and literature review. Surg Neurol Int. 2016;7(18):S481.

Zong-Wen S, Shuang-Yan Y, Feng-Lei D, et al. Radiotherapy for Adult Medulloblastoma: Evaluation of Helical Tomotherapy, Volumetric Intensity Modulated Arc Therapy, and Three-Dimensional Conformal Radiotherapy and the Results of Helical Tomotherapy Therapy. Biomed Res Int. 2018;2018:1–8.

Smoll NR, Drummond KJ. The incidence of medulloblastomas and primitive neurectodermal tumours in adults and children. J Clin Neurosci. 2012 Nov;19(11):1541–4.

Giordana MT, Schiffer P, Lanotte M, et al. Epidemiology of adult medulloblastoma. Int J Cancer. 1999 Mar 1;80(5):689–92.

Franceschi E, Hofer S, Brandes AA, et al. EANO–EURACAN clinical practice guideline for diagnosis, treatment, and follow-up of post-pubertal and adult patients with medulloblastoma. Lancet Oncol. 2019;20(12):e715–28.

Choi JY. Medulloblastoma: Current Perspectives and Recent Advances. Brain Tumor Res Treat. 2023;11(1):28.

Louis DN, Perry A, Wesseling P, et al. The 2021 WHO classification of tumors of the central nervous system: A summary. Neuro Oncol. 2021;23(8):1231–51.

Luque R, Benavides M, del Barco S, et al. SEOM clinical guideline for management of adult medulloblastoma. Clin Transl Oncol. 2021;23(5):940–7.

Tomy N, Souza RND, Chandraguthi SG, Rao S. Dosimetric Comparison of Three - Dimensional Conformal Radiation Therapy ( 3DCRT ) and Posterior Partial Arc Volumetric Modulated Arc Therapy ( VMAT ) Plan for Craniospinal Irradiation. Iranian J Med Phys. 2023;20(6):372-9.

Infusino E. Clinical utility of RapidArcTM radiotherapy technology. Cancer Manag Res. 2015 Nov;345.

Bhalla N, Palanisamy M, Anand G, et al. EP-1810 Comparison of absorbed dose between medium and water on Monte Carlo algorithm for VMAT plan. Radiother Oncol. 2019 Apr;133:S981.

Brandes AA, Franceschi E, Tosoni A, et al. Adult neuroectodermal tumors of posterior fossa (medulloblastoma) and of supratentorial sites (stPNET). Crit Rev Oncol Hematol. 2009 Aug;71(2):165–79.

Chan AW, Tarbell NJ, Black PM, et al. Adult Medulloblastoma: Prognostic Factors and Patterns of Relapse. Neurosurgery. 2000 Sep 1;47(3):623–32.

Ropper AH BR. Intracranial neoplasms and paraneoplastic disorder. In: AH Ropper RB, editor. Adams and Victor’s principles of neurology. 8th ed. New York: McGraw-Hill; 2005. p. 144–67.

Ibis K, Karadeniz A, Meral R, et al. The Prognostic Factors and Outcome of Adult Medulloblastoma: Where We Stand. Int Surg. 2016 Jul 1;101(7–8):352–60.

Tongwan D, Peerawong T, Oonsiri S. Craniospinal irradiation in the supine position: A dosimetric analysis. Asian Biomed. 2009;3(6):699–708.

Chen J, Chen C, Atwood TF, et al. Volumetric modulated arc therapy planning method for supine craniospinal irradiation. J Radiat Oncol. 2012;1(3):291–7.

Neelakandan V, Christy SS, Mukherji A, Reddy KS. Craniospinal irradiation by rapid Arc ® technique in supine position: A dosimetric and clinical analysis. J Curr Oncol. 2018;1(1):16.

Athiyaman H, Mayilvaganan A, Singh D. A simple planning technique of craniospinal irradiation in the eclipse treatment planning system. J Med Phys. 2014;39(4):251.


Refbacks

  • There are currently no refbacks.


Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.