A case of relapsed medulloblastoma treated with intensity-modulated radiotherapy and temozolomide.
We report a case of relapsed high-risk non-metastatic medulloblastoma in a 14-year-old boy, which was treated with intensity-modulated radiotherapy (IMRT) and temozolomide (TMZ). At the age of 11, the patient underwent an MRI-confirmed incomplete resection of a fourth-ventricle medulloblastoma, followed by conventional chemotherapy, craniospinal irradiation (55.8 Gy, 1.8 Gy/fraction) and then myeloablative chemotherapy followed by peripheral blood progenitor cell rescue. After 18 months of complete remission following the completion of chemotherapy, MRI showed a 2.5-cm mass in the olfactory notch. The patient underwent IMRT (45 Gy, 1.8 Gy/fraction) with concomitant administration of TMZ (180 mg/m2, 5 days every 21 days), which was well tolerated. After 5 cycles of TMZ, MRI showed complete remission with no evidence of the mass. TMZ was continued for another 5 cycles and then stopped. At 14 months from the completion of IMRT, a new MRI scan showed multiple nodular relapses around the fourth ventricle and the patient is currently treated with oral etoposide.
Mascarin
Maurizio
M
Department of Radiotherapy, Centro di Riferimento Oncologico, Aviano, Pordenone, Italy.
Dall'Oglio
Stefano
S
Palazzi
Mario
M
Sartor
Giovanna
G
Marradi
Pier Luigi
PL
Romano
Mario
M
Maluta
Sergio
S
D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use*; D002528:Cerebellar Neoplasms / Q000628:therapy*; D002648:Child; D003131:Combined Modality Therapy; D003606:Dacarbazine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008527:Medulloblastoma / Q000628:therapy*; D009364:Neoplasm Recurrence, Local / Q000628:therapy; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods*; D000077204:Temozolomide
D018906:Antineoplastic Agents, Alkylating; D003606:Dacarbazine; D000077204:Temozolomide