title: A case of relapsed medulloblastoma treated with intensity-modulated radiotherapy and temozolomide.
abstract: 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.
authors.affiliation: Department of Radiotherapy, Centro di Riferimento Oncologico, Aviano, Pordenone, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Mascarin
authors.forename: Stefano
authors.initials: S
authors.lastname: Dall'Oglio
authors.forename: Mario
authors.initials: M
authors.lastname: Palazzi
authors.forename: Giovanna
authors.initials: G
authors.lastname: Sartor
authors.forename: Pier Luigi
authors.initials: PL
authors.lastname: Marradi
authors.forename: Mario
authors.initials: M
authors.lastname: Romano
authors.forename: Sergio
authors.initials: S
authors.lastname: Maluta
mesh_terms: 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
chemical_list: D018906:Antineoplastic Agents, Alkylating; D003606:Dacarbazine; D000077204:Temozolomide