title: Brainstem-sparing craniospinal irradiation delivered with pencil beam scanning proton therapy.
abstract: Delivery of craniospinal irradiation (CSI) is a curative approach to recurrent ependymoma, but is associated with risks from re-irradiation, particularly of the brainstem. Pencil beam scanning proton therapy allows delivery of CSI with sparing of normal tissues. Here, we describe a case of brainstem-sparing CSI that resulted in excellent coverage of the craniospinal axis with minimal radiation to brainstem. This is a novel concept that compares favorably to previously described methods using x-rays that may result in underdosing of surrounding tissues in effort to spare brainstem.
authors.affiliation: Department of Radiation Oncology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Christine
authors.initials: C
authors.lastname: Hill-Kayser
authors.forename: Maura
authors.initials: M
authors.lastname: Kirk
mesh_terms: D001933:Brain Stem; D002648:Child; D061888:Craniospinal Irradiation; D004806:Ependymoma / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D015192:Infratentorial Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D061766:Proton Therapy
keywords: craniospinal irradiation; ependymoma; pencil beam scanning; proton therapy