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Case Report
Volumetric modulated arc therapy (VMAT) craniospinal image-guided radiotherapy and chemotherapy for high-risk medulloblastoma in adults: A case report with analysis of the technique
1 Department of Radiotherapy/Oncology, University Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
Address correspondence to:
Michael I Koukourakis
MD, Department of Radiotherapy/Oncology, Democritus University of Thrace, Alexandroupolis 68100,
Greece
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Article ID: 100087Z10CN2021
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Nanos CA, Abatzoglou I, Koukourakis MI. Volumetric modulated arc therapy (VMAT) craniospinal image-guided radiotherapy and chemotherapy for high-risk medulloblastoma in adults: A case report with analysis of the technique. J Case Rep Images Oncology 2021;7:100087Z10CN2021.ABSTRACT
Introduction: Adult medulloblastoma is a rare disease. Due to the length of the body areas demanding irradiation, medulloblastoma is a challenging malignancy for the development of advanced radiotherapy techniques.
Case Report: We describe a volumetric modulated arc therapy (VMAT) technique applied under image-guided radiation therapy (IGRT) for craniospinal irradiation, offered to a patient with high risk medulloblastoma, together with cisplatin/temozolomide chemotherapy. Three areas of irradiation (cranial, thoracic, and lumbar) were defined, with shifting the gaps between them at a weekly basis (two shifts within the three weeks of therapy). The biological equivalent “normalized total dose” (NTD) to the craniospinal axis and the gaps between the three VMAT-treated areas were calculated for α/β-ratio of 2 Gy, and all the data from dose volume histograms (DVHs) are shown.
Conclusion: The technique is reliable delivering with safety and accuracy the desirable radiation dose, with biologically and oncologically acceptable dose-deviations within the field-gaps. The tolerance of the radiochemotherapy regimen was excellent.
Keywords: Craniospinal irradiation, Medulloblastoma, VMAT
SUPPORTING INFORMATION
Author Contributions
Christos A Nanos - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Ioannis Abatzoglou - Acquisition of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Michael I Koukourakis - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent to use anonymously clinical and laboratory data for research purposes was obtained before the onset of therapy.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2021 Christos A Nanos et al.. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
