Radiotherapy in pediatric medulloblastoma: quality assessment of Pediatric Oncology Group Trial 9031
Quality Assurance Review Center; Department of Radiation Oncology
Health Services Administration | Neoplasms | Oncology | Radiology
PURPOSE: To evaluate the potential influence of radiotherapy quality on survival in high-risk pediatric medulloblastoma patients.
METHODS AND MATERIALS: Trial 9031 of the Pediatric Oncology Group (POG) aimed to study the relative benefit of cisplatin and etoposide randomization of high-risk patients with medulloblastoma to preradiotherapy vs. postradiotherapy treatment. Two-hundred and ten patients were treated according to protocol guidelines and were eligible for the present analysis. Treatment volume (whole brain, spine, posterior fossa, and primary tumor bed) and dose prescription deviations were assessed for each patient. An analysis of first site of failure was undertaken. Event-free and overall survival rates were calculated. A log-rank test was used to determine the significance of potential survival differences between patients with and without major deviations in the radiotherapy procedure.
RESULTS: Of 160 patients who were fully evaluable for all treatment quality parameters, 91 (57%) had 1 or more major deviations in their treatment schedule. Major deviations by treatment site were brain (26%), spinal (7%), posterior fossa (40%), and primary tumor bed (17%). Major treatment volume or total dose deviations did not significantly influence overall and event-free survival.
CONCLUSIONS: Despite major treatment deviations in more than half of fully evaluable patients, underdosage or treatment volume misses were not associated with a worse event-free or overall survival.
DOI of Published Version
Int J Radiat Oncol Biol Phys. 2006 Apr 1;64(5):1325-30. Epub 2006 Jan 18. Link to article on publisher's site
International journal of radiation oncology, biology, physics
Miralbell R, FitzGerald TJ, Laurie F, Kessel S, Glicksman A, Friedman HS, Urie M, Kepner JL, Zhou T, Chen Z, Barnes P, Kun L, Tarbell NJ. (2006). Radiotherapy in pediatric medulloblastoma: quality assessment of Pediatric Oncology Group Trial 9031. IROC Rhode Island (QARC) Publications. https://doi.org/10.1016/j.ijrobp.2005.11.002. Retrieved from https://escholarship.umassmed.edu/qarc/47