title: Conformal radiotherapy, reduced boost volume, hyperfractionated radiotherapy, and online quality control in standard-risk medulloblastoma without chemotherapy: results of the French M-SFOP 98 protocol.
abstract: OBJECTIVE
  Between December 1998 and October 2001, patients <19 years old were treated for standard-risk medulloblastoma according to the Medulloblastome-Société Française d'Oncologie Pédiatrique 1998 (M-SFOP 98) protocol. Patients received hyperfractionated radiotherapy (36 Gy in 36 fractions) to the craniospinal axis, a boost with conformal therapy restricted to the tumor bed (to a total dose of 68 Gy in 68 fractions), and no chemotherapy. Records of craniospinal irradiation were reviewed before treatment start.
  
  
  RESULTS
  A total of 48 patients were considered assessable. With a median follow-up of 45.7 months, the overall survival and progression-free survival rate at 3 years was 89% and 81%, respectively. Fourteen major deviations were detected and eight were corrected. No relapses occurred in the frontal region and none occurred in the posterior fossa outside the boost volume. Nine patients were available for volume calculation without reduction of the volume irradiated. We observed a reduction in the subtentorial volume irradiated to >60 Gy, but a slight increase in the volume irradiated to 40 Gy. No decrease in intelligence was observed in the 22 children tested during the first 2 years.
  
  
  CONCLUSIONS
  This hyperfractionated radiotherapy protocol with a reduced boost volume and without chemotherapy was not associated with early relapses in children. Moreover, intellectual function seemed to be preserved. These results are promising.
authors.affiliation: Department of Radiotherapy, Centre Léon Bérard, Lyon, France. carrie@lyon.fnclcc.fr
authors.forename: Christian
authors.initials: C
authors.lastname: Carrie
authors.forename: Xavier
authors.initials: X
authors.lastname: Muracciole
authors.forename: Frédéric
authors.initials: F
authors.lastname: Gomez
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Habrand
authors.forename: Mohamed
authors.initials: M
authors.lastname: Benhassel
authors.forename: Martine
authors.initials: M
authors.lastname: Mege
authors.forename: Marc
authors.initials: M
authors.lastname: Mahé
authors.forename: Philippe
authors.initials: P
authors.lastname: Quetin
authors.forename: Jean Philippe
authors.initials: JP
authors.lastname: Maire
authors.forename: Françoise
authors.initials: F
authors.lastname: Soum
authors.forename: Marie Helene
authors.initials: MH
authors.lastname: Baron
authors.forename: Pierre
authors.initials: P
authors.lastname: Clavere
authors.forename: Sophie
authors.initials: S
authors.lastname: Chapet
authors.forename: Zineb
authors.initials: Z
authors.lastname: Gaci
authors.forename: Helene
authors.initials: H
authors.lastname: Kolodie
authors.forename: Philippe
authors.initials: P
authors.lastname: Maingon
authors.forename: Bernard
authors.initials: B
authors.lastname: Vie
authors.forename: Valérie
authors.initials: V
authors.lastname: Bernier
authors.forename: Claire
authors.initials: C
authors.lastname: Alapetite
authors.forename: Sylvette
authors.initials: S
authors.lastname: Hoffstetter
authors.forename: Jacques
authors.initials: J
authors.lastname: Grill
authors.forename: Frédéric
authors.initials: F
authors.lastname: Lafay
mesh_terms: D000293:Adolescent; D002528:Cerebellar Neoplasms / Q000532:radiotherapy*; D002648:Child; D003071:Cognition; D019583:Dose Fractionation, Radiation; D005240:Feasibility Studies; D005602:France; D006801:Humans; D008527:Medulloblastoma / Q000532:radiotherapy*; D009364:Neoplasm Recurrence, Local; D010865:Pilot Projects; D011786:Quality Control; D020266:Radiotherapy, Conformal / Q000379:methods*; D016019:Survival Analysis; D016896:Treatment Outcome