Comparison of supine and prone craniospinal irradiation in children with medulloblastoma

Jonathan Verma, Ali Mazloom, Bin S. Teh, Michael South, E. Brian Butler, Arnold C. Paulino

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Purpose: To compare port film rejection and treatment outcome according to craniospinal irradiation (CSI) position for medulloblastoma. Methods and materials: We retrospectively searched for patients ≤. 19 years treated with CSI for medulloblastoma at 1 department. We collected the following data: age; sex; risk group; need for general anesthesia; radiation therapy (RT) dose and fractionation; and the acceptance or rejection of weekly port films during treatment. We also collected data on outcomes, including neuraxis recurrence and possible complications such as myelitis. Results: Of 46 children identified, 23 were treated prone (median age, 8.1 years) and 23 supine (median age, 7.2 years). High-risk disease was seen in 26% of prone and 35% of supine patients (P = .25). There was no difference in use of general anesthesia between those treated prone versus supine (57% vs 61%). The rejection rate of cranial port films in the prone position was 35%, which was significantly higher than the rate of 8% in patients treated supine (P < .0001). The 5-year progression-free (P = .37) and overall survival (P = .18) rates were 62% and 67% for prone and 76% and 84% for supine patients. There were no isolated junctional failures or radiation myelitis in either CSI position. Conclusions: The supine position for CSI was found to have similar survival outcomes compared with the prone position. A higher proportion of rejected cranial port films was seen in children treated in the prone position.

Original languageEnglish (US)
Pages (from-to)93-98
Number of pages6
JournalPractical Radiation Oncology
Issue number2
StatePublished - Mar 1 2015

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging


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