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Is it acceptable to do IFRT rather than whole posterior fossa boost for high risk medulloblastoma?
If so in what circumstances and what margin is acceptable? ACNS 0331 recently showed no difference in outcomes when comparing IFRTboost vs PF boost for standard risk but high risk medulloblastoma trials still do PF boost.
Answer from: Radiation Oncologist at Academic Institution
Based on dosimetric patterns of failure and early pilot studies of tumor bed boost from the University of Michigan and Memorial Sloan Kettering, respectively, the recently completed ACNS0331 clinical trial randomized patients with average risk medulloblastoma to whole posterior fossa or tumor bed bo...
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Answer from: Radiation Oncologist at Academic Institution
I agree completely with @Christopher L. Tinkle. I would like to add emphasis to his comment that high risk disease is very heterogeneous. I think it's very reasonable to perform a tumor bed boost if someone is high risk because of cells in CSF, probably Ok for an isola...
Answer from: Radiation Oncologist at Community Practice
I also would concur. The emphasis on repeat imaging of the PF with MRI near to the time of boost is also very relevant. It is not uncommon for the PF resection cavity to evolve / collapse over time. As a result pre-surgical MRI along with an MRI taken near to the time of Boost are important. A...