Abstract
3D conformal radiation therapy (3DCRT) and intensity-modulated radiation therapy (IMRT) are both commonly utilized for pediatric brain tumors. 3DCRT has been available for a longer period. There is protracted follow-up on patients treated with 3DCRT. IMRT is a newer technology that developed in parallel with advances in other radiation delivery such as image guidance. Similar tumor coverage can be either 3DCRT or IMRT. They differ in the ability to achieve conformity around irregularly volumes. IMRT can achieve highly conformal plans although intense modulation can impact dose homogeneity. VMAT is a form of IMRT rotational. The addition of static or rotational beams can expose nontarget tissue to lose dose radiation. The balance of tumor coverage and dose homogeneity against the impact of collateral radiation to nontarget tissues impacting neurocognitive functioning for cranial radiation or anticipated renal and cardiopulmonary function in craniospinal radiation is the main factor in deciding what the optimal photon radiation treatment is for pediatric CNS tumors.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Aoyama H et al (2006) Integral radiation dose to normal structures with conformal external beam radiation. Int J Radiat Oncol Biol Phys 64(3):962–967
Bakiu E et al (2013) Comparison of 3D CRT and IMRT treatment plans. Acta Inform Med 21(3):211–212
Bandurska-Luque A et al (2015) Prospective study on dosimetric comparison of helical tomotherapy and 3DCRT for craniospinal irradiation—a single institution experience. Rep Pract Oncol Radiother 20(2):145–152
Blomstrand M et al (2012) Estimated clinical benefit of protecting neurogenesis in the developing brain during radiation therapy for pediatric medulloblastoma. Neuro Oncol 14(7):882–889
Chang A et al (2014) Pediatric proton therapy: patterns of care across the United States. Int J Particle Ther 1(2):357–367
Chen MJ et al (2010) Intensity-modulated and 3D-conformal radiotherapy for whole-ventricular irradiation as compared with conventional whole-brain irradiation in the management of localized central nervous system germ cell tumors. Int J Radiat Oncol Biol Phys 76(2):608–614
D’Souza WD, Rosen II (2003) Nontumor integral dose variation in conventional radiotherapy treatment planning. Med Phys 30(8):2065–2071
Eriksson PS et al (1998) Neurogenesis in the adult human hippocampus. Nat Med 4(11):1313–1317
Fenwick JD et al (2006) Tomotherapy and other innovative IMRT delivery systems. Semin Radiat Oncol 16(4):199–208
Fogliata A et al (2009) On the performances of intensity modulated protons, rapidarc and helical tomotherapy for selected paediatric cases. Radiat Oncol 4:2
Greenfield BJ et al (2015) Long-term disease control and toxicity outcomes following surgery and intensity modulated radiation therapy (IMRT) in pediatric craniopharyngioma. Radiother Oncol 114(2):224–229
Hall EJ, Wuu CS (2003) Radiation-induced second cancers: the impact of 3D-CRT and IMRT. Int J Radiat Oncol Biol Phys 56(1):83–88
Harron E, Lewis J (2012) Bowel sparing in pediatric cranio-spinal radiotherapy: a comparison of combined electron and photon and helical TomoTherapy techniques to a standard photon method. Med Dosim 37(2):140–144
Hellstrom NA et al (2009) Differential recovery of neural stem cells in the subventricular zone and dentate gyrus after ionizing radiation. Stem Cells 27(3):634–641
Hermanto U et al (2007) Intensity-modulated radiotherapy (IMRT) and conventional three-dimensional conformal radiotherapy for high-grade gliomas: does IMRT increase the integral dose to normal brain? Int J Radiat Oncol Biol Phys 67(4):1135–1144
Huang E et al (2002) Intensity-modulated radiation therapy for pediatric medulloblastoma: early report on the reduction of ototoxicity. Int J Radiat Oncol Biol Phys 52(3):599–605
Kazda T et al (2015) Volumetric modulated arc therapy for hippocampal-sparing radiotherapy in transformed low-grade glioma: a treatment planning case report. Cancer Radiother 19(3):187–191
Koshy M et al (2004) Extra-target doses in children receiving multileaf collimator (MLC) based intensity modulated radiation therapy (IMRT). Pediatr Blood Cancer 42(7):626–630
Lee YK et al (2012) Development and evaluation of multiple isocentric volumetric modulated arc therapy technique for craniospinal axis radiotherapy planning. Int J Radiat Oncol Biol Phys 82(2):1006–1012
Lee JS et al (2016) Increased risk of second malignant neoplasms in adolescents and young adults with cancer. Cancer 122(1):116–123
Lightstone AW et al (2012) Cone beam CT (CBCT) evaluation of inter- and intra-fraction motion for patients undergoing brain radiotherapy immobilized using a commercial thermoplastic mask on a robotic couch. Technol Cancer Res Treat 11(3):203–209
Mackie TR (2006) History of tomotherapy. Phys Med Biol 51(13):R427–R453
Mansur DB et al (2007) Measured peripheral dose in pediatric radiation therapy: a comparison of intensity-modulated and conformal techniques. Radiother Oncol 82(2):179–184
Mascarin M et al (2011) Helical tomotherapy in children and adolescents: dosimetric comparisons, opportunities and issues. Cancers (Basel) 3(4):3972–3990
Merchant TE et al (1999) Preliminary results of conformal radiation therapy for medulloblastoma. Neuro Oncol 1(3):177–187
Merchant TE et al (2006) Phase II trial of conformal radiation therapy for pediatric patients with craniopharyngioma and correlation of surgical factors and radiation dosimetry with change in cognitive function. J Neurosurg 104(2 suppl):94–102
Merchant TE et al (2009) Late effects of conformal radiation therapy for pediatric patients with low-grade glioma: prospective evaluation of cognitive, endocrine, and hearing deficits. J Clin Oncol 27(22):3691–3697
Merchant TE et al (2013) Disease control after reduced volume conformal and intensity modulated radiation therapy for childhood craniopharyngioma. Int J Radiat Oncol Biol Phys 85(4):e187–e192
Monje ML et al (2007) Impaired human hippocampal neurogenesis after treatment for central nervous system malignancies. Ann Neurol 62(5):515–520
Moteabbed M et al (2014) The risk of radiation-induced second cancers in the high to medium dose region: a comparison between passive and scanned proton therapy, IMRT and VMAT for pediatric patients with brain tumors. Phys Med Biol 59(12):2883–2899
Oh KS et al (2011) Outcomes of multidisciplinary management in pediatric low-grade gliomas. Int J Radiat Oncol Biol Phys 81(4):e481–e488
Parker WA, Freeman CR (2006) A simple technique for craniospinal radiotherapy in the supine position. Radiother Oncol 78(2):217–222
Paulino AC et al (2013) Intensity-modulated radiotherapy (IMRT) in pediatric low-grade glioma. Cancer 119(14):2654–2659
Penagaricano J et al (2009) Pediatric craniospinal axis irradiation with helical tomotherapy: patient outcome and lack of acute pulmonary toxicity. Int J Radiat Oncol Biol Phys 75(4):1155–1161
Pirzkall A et al (2002) The effect of beam energy and number of fields on photon-based IMRT for deep-seated targets. Int J Radiat Oncol Biol Phys 53(2):434–442
Polkinghorn WR et al (2011) Disease control and ototoxicity using intensity-modulated radiation therapy tumor-bed boost for medulloblastoma. Int J Radiat Oncol Biol Phys 81(3):e15–e20
Qi XS et al (2012) Potential for improved intelligence quotient using volumetric modulated arc therapy compared with conventional 3-dimensional conformal radiation for whole-ventricular radiation in children. Int J Radiat Oncol Biol Phys 84(5):1206–1211
Schroeder TM et al (2008) Intensity-modulated radiation therapy in childhood ependymoma. Int J Radiat Oncol Biol Phys 71(4):987–993
St Clair WH et al (2004) Advantage of protons compared to conventional X-ray or IMRT in the treatment of a pediatric patient with medulloblastoma. Int J Radiat Oncol Biol Phys 58(3):727–734
Tarbell NJ et al (2000) The challenge of conformal radiotherapy in the curative treatment of medulloblastoma. Int J Radiat Oncol Biol Phys 46(2):265–266
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2018 Springer International Publishing AG
About this chapter
Cite this chapter
Daniels, T.B., Laack, N.N. (2018). Conformal Radiation Therapy for Pediatric CNS Tumors. In: Mahajan, A., Paulino, A. (eds) Radiation Oncology for Pediatric CNS Tumors. Springer, Cham. https://doi.org/10.1007/978-3-319-55430-3_25
Download citation
DOI: https://doi.org/10.1007/978-3-319-55430-3_25
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-55428-0
Online ISBN: 978-3-319-55430-3
eBook Packages: MedicineMedicine (R0)