Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Mar 1;58(2):238-246.
doi: 10.1093/jrr/rrw095.

Craniospinal irradiation using helical tomotherapy for central nervous system tumors

Sanziana R I Schiopu  1 , Gregor Habl  2 , Matthias Häfner  1 , Sonja Katayama  1 , Klaus Herfarth  1 , Juergen Debus  1 , Florian Sterzing  1
Affiliations

Craniospinal irradiation using helical tomotherapy for central nervous system tumors

Sanziana R I Schiopu et al. J Radiat Res. .

Abstract

The aim of this study was to describe early and late toxicity, survival and local control in 45 patients with primary brain tumors treated with helical tomotherapy craniospinal irradiation (HT-CSI). From 2006 to 2014, 45 patients with central nervous system malignancies were treated with HT-CSI. The most common tumors were medulloblastoma in 20 patients, ependymoma in 10 patients, intracranial germinoma (ICG) in 7 patients, and primitive neuroectodermal tumor in 4 patients. Hematological toxicity during treatment included leukopenia Grades 1-4 (6.7%, 33.3%, 37.8% and 17.8%, respectively), anemia Grades 1-4 (44.4%, 22.2%, 22.2% and 0%, respectively) and thrombocytopenia Grades 1-4 (51.1%, 15.6%, 15.6% and 6.7%, respectively). The most common acute toxicities were nausea, vomiting, fatigue, loss of appetite, alopecia and neurotoxicity. No Grade 3 or higher late toxicity occurred. The overall 3- and 5-year survival rates were 80% and 70%, respectively. Survival for the main tumor entities included 3- and 5-year survival rates of 80% and 70%, respectively, for patients with medulloblastoma, 70% for both in patients with ependymoma, and 100% for both in patients with ICG. Relapse occurred in 11 patients (24.4%): 10 with local and 1 with multifocal relapse. One patient experienced a secondary cancer. M-status and the results of the re-evaluation at the end of treatment were significantly related to survival. Survival after HT-CSI was in line with the existing literature, and acute treatment-induced toxicity resolved quickly. Compared with conventional radiotherapy, HT offers benefits such as avoiding gaps and junctions, sparing organs, and better and more homogeneous dose distribution and coverage of the target volume.

Keywords: craniospinal irradiation; ependymoma; helical tomotherapy; intracranial germinoma; medulloblastoma; radiation therapy.

PubMed Disclaimer

Figures

Fig. 1.
Fig. 1.
Kaplan-Meier overall survival and recurrence-free survival estimates: an overview for all patients with primary brain tumors treated with helical tomotherapy craniospinal irradiation. OS, overall survival; RFS, relapse free survival.
See this image and copyright information in PMC

References

    1. Penagaricano J, Moros E, Corry P, et al. . Pediatric craniospinal axis irradiation with helical tomotherapy: patient outcome and lack of acute pulmonary toxicity. Int J Radiat Oncol Biol Phys 2009;75:1155–61. - PubMed
    1. Penagaricano J-A, Papanikolaou N, Yan Y, et al. . Feasibility of cranio-spinal axis radiation with the Hi-Art tomotherapy system. Radiother Oncol 2005;76:72–8. - PubMed
    1. Sterzing F., Schubert K, Sroka-Perez G, et al. . Helical tomotherapy. Experiences of the first 150 patients in Heidelberg. Strahlenther Onkol 2008;184:8–14. - PubMed
    1. Calaminus G, Kortmann R, Worch J, et al. . SIOP CNS GCT 96: final report of outcome of a prospective, multinational nonrandomized trial for children and adults with intracranial germinoma, comparing craniospinal irradiation alone with chemotherapy followed by focal primary site irradiation for patients with localized disease. Neuro Oncol 2013;15:788–96. - PMC - PubMed
    1. Ogawa K, Shikama N, Toita T, et al. . Long-term results of radiotherapy for intracranial germinoma: a multi-institutional retrospective review of 126 patients. Int J Radiat Oncol Biol Phys 2004;58:705–13. - PubMed

LinkOut - more resources