Radiotherapy in pediatric medulloblastoma: Quality assessment of Pediatric Oncology Group Trial 9031
- Quality Assurance Review Committee, Providence, RI (United States) and Department of Radiation Oncology, University Hospital, Geneva (Switzerland)
- Quality Assurance Review Committee, Providence, RI (United States)
- Pediatric Neuro-Oncology Division, Duke South Hospital, Durham, NC (United States)
- Roswell Park Cancer Institute, Buffalo, NY (United States)
- Operations Center, Children's Oncology Group, Arcadia, CA (United States)
- Department of Radiology, Stanford University, Stanford, CA (United States)
- Department of Radiation Oncology, St. Jude Children's Research Hospital, Memphis, TN (United States)
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA (United States)
Purpose: To evaluate the potential influence of radiotherapy quality on survival in high-risk pediatric medulloblastoma patients. Methods and Materials: Trial 9031 of the Pediatric Oncology Group (POG) aimed to study the relative benefit of cisplatin and etoposide randomization of high-risk patients with medulloblastoma to preradiotherapy vs. postradiotherapy treatment. Two-hundred and ten patients were treated according to protocol guidelines and were eligible for the present analysis. Treatment volume (whole brain, spine, posterior fossa, and primary tumor bed) and dose prescription deviations were assessed for each patient. An analysis of first site of failure was undertaken. Event-free and overall survival rates were calculated. A log-rank test was used to determine the significance of potential survival differences between patients with and without major deviations in the radiotherapy procedure. Results: Of 160 patients who were fully evaluable for all treatment quality parameters, 91 (57%) had 1 or more major deviations in their treatment schedule. Major deviations by treatment site were brain (26%), spinal (7%), posterior fossa (40%), and primary tumor bed (17%). Major treatment volume or total dose deviations did not significantly influence overall and event-free survival. Conclusions: Despite major treatment deviations in more than half of fully evaluable patients, underdosage or treatment volume misses were not associated with a worse event-free or overall survival.
- OSTI ID:
- 20793414
- Journal Information:
- International Journal of Radiation Oncology, Biology and Physics, Vol. 64, Issue 5; Other Information: DOI: 10.1016/j.ijrobp.2005.11.002; PII: S0360-3016(05)02868-3; Copyright (c) 2006 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); ISSN 0360-3016
- Country of Publication:
- United States
- Language:
- English
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