Medulloblastoma in Children
Abstract
โรค medulloblastoma เป็นโรคมะเร็งในสมองที่พบมากเป็นอันดับหนึ่งในกลุ่มผู้ป่วยเด็กและวัยรุ่น โดยการรักษาหลัก จะเป็นการรักษาร่วมทั้ง การผ่าตัด การฉายรังสี และยาเคมีบำบัด การฉายรังสีมีบทบาทสำคัญเพื่อเพิ่มอัตราการรอดชีวิต และลดการกลับมาเป็นซํ้าของโรค ขอบเขตการฉายรังสีจะเป็นลักษณะ craniospinal axis (CSI) เนื่องจากพบการแพร่กระจายไปตาม subarachnoid space ได้บ่อย อย่างไรก็ตามต้องระวังผลข้างเคียงจากการฉายรังสี จึงมีการศึกษาพัฒนาวิธีการรักษาและเทคนิคการฉายรังสี เช่น การลดปริมาณรังสีโดยให้ร่วมกับยาเคมีบำบัด รวมถึงการฉายรังสี multiple field หรือการฉายรังสีโปรตอนเพื่อลดผลข้างเคียงที่อาจเกิดขึ้น
References
MacDonald SM. Central Nervous System Tumor in Children. In:Bogart JA, Buchholz TA, Foote RL, Kun LE, Mehta MP, editors. Clinical Radiation Oncology. 4rdedition. Philadephia:Elsevier Saunders;2016.
Carolyn RF, Jean PF, Roger ET. Central Nervous System Tumors in Children Chapter. In:Halperin EC, Perez CA, Brady LW, editors. Principle and Practice of Radiation Oncology. 6th edition. Philadephia:Lippincott Williams and Wilkins;2013.
Kun EL, MacDonald S, Tarbel NJ. Tumor in the posterior fossa and spinal canal. In:Halperin EC, Constine LS, Tarbel NJ, Kun EL, editors. Pediatric Radiation Oncology. 5thedition:Lippincott Williams and Wilkins;2010.
Jones BV. Neoplasm and Tumor like Lesions. In:Osborn AG, Blaser S, Salzman KL, Katzman GL, Provenzale J, editors. Diagnostic imaging brain. Canada:Amirsys;2004.
Monje J, Beachy PA, Fisher PG.Hedgehogs, flies, Wnts and MYCs: the time has come for many things in medulloblastoma.J Clin Oncol 2011;29:1395-8.
Northcott PA, Shih DJH, Peacock J, Garzia L, Morrissy AS, Zichner T, et al. Subgroup-specific structural variation across 1,000 medulloblastoma genomes. Nature 2012;488:49-56.
Gajjar A., Doyley TE. SJMB12: A Clinical and Molecular Risk-Directed Therapy for Newly Diagnosed Medulloblastoma/PNET. 2016 [cited 2016 Feb 15]. Available from: https://www.clinicaltrials.gov/ct2/ show/NCT01878617
Gaillard F.Medulloblastoma. 2015 [cited 2015 Dec 1]. Available from: http://radiopaedia.org/articles/ Medulloblastoma
Fouladi M, Gajjar A, Boyett JM, Walter AW, Thompson SJ, Merchant TE, et al. Comparison of CSF cytology and spinal magnetic resonance imaging in the detection of leptomeningeal disease in pediatric medulloblastoma or primitive neuroectodermal tumor. J Clin Oncol 1999;17:3234-3237.
Zeltzer PM, Boyett JM, Finlay JL, Albright AL, Rorke LB, Milstein JM, et al. Metastasis stage, adjuvant treatment, and residual tumor are prognostic factors for medulloblastoma in children: conclusions from the children's cancer group 921 Randomized Phase III Study. J Clin Oncol 1999;17:832-45.
Bailey P, Cushing H. Medulloblastoma cerebelli. A common type of midcerebellar glioma of childhood. Arch Neurol Neurosurg Psychiatry.1925;14:192–224.
Rieken S, Mohr A, Habermehl D, Welzel T, Lindel K, Witt O, et al. Outcome and prognostic factors of radiation therapy for medulloblastoma. Int J Radiat Oncol Biol Phys. 2011;81:e7-e13.
Taylor RE, Bailey CC, Robinson K, Weston CL, Ellison D, Ironside J, et al. Results of a randomized study of preradiation chemotherapy versusradiotherapy alone for nonmetastatic medulloblastoma: The International Society of Paediatric Oncology/United Kingdom Children's Cancer Study Group PNET-3 Study. J Clin Oncol. 2003;21:1581-91.
Kieffer-Renaux V, Bulteau C, Grill J, Kalifa C, Viguier D, Jambaque I.Patterns of neuropsychological deficits in children with medulloblastoma according to craniospatial irradiation doses. Dev Med Child Neurol. 2000;42:741-5.
Silber JH, Radcliffe J, Peckham V, Perilongo G, Kishnani P, Fridman M, et al. Whole-brain irradiation and decline in intelligence: the influence of dose and age on IQ score. J Clin Oncol. 1992;10:1390-6.
Thomas PR, Deutsch M, Kepner JL, Boyett JM, Krischer J, Aronin P, et al. Low-stage medulloblastoma: final analysis of trial comparing standard-dose with reduced-dose neuraxis irradiation. J Clin Oncol. 2000;18:3004.
Bailey CC, Gnekow A, Wellek S, Jones M, Round C, Brown J, et al. Prospective randomised trial of chemotherapy given before radiotherapy in childhood medulloblastoma. International Society of Paediatric Oncology (SIOP) and the (German) Society of Paediatric Oncology. Med Pediatr Onc. 1995; 25:166-78.
Packer RJ, Goldwein J, Nicholson HS, Vezina LG, Allen JC, Ris MD,et al. Treatment of children with medulloblastomas with reduced-dose craniospinal radiation therapy and adjuvant chemotherapy: A Children's Cancer Group Study. J Clin Oncol. 1999;17:2127-36.
Mulhern RK, Kepner JL, Thomas PR, Armstrong FD, Friedman HS, Kun LE. Neuropsychologic functioning of survivors of childhood medulloblastoma randomized to receive conventional or reduced-dose craniospinal irradiation: a Pediatric Oncology Group study. J Clin Oncol. 1998;16:1723-1728
Ris MD, Packer R, Goldwein J, Wallace DJ, Boyett JM. Intellectual outcome after reduced-dose radiation therapy plus adjuvant chemotherapy for medulloblastoma: A Children’s Cancer Group Study. J Clin Oncol. 2001;19:3470-3476.
Packer RJ, Gajjar A, Vezina G, Adams LR, Burger PC, Patricia L,et al. Phase III study of craniospinal radiation therapy followed by adjuvant chemotherapy for newly diagnosed average-risk medulloblastoma. J Clin Oncol. 2006;24:4202-8.
Lannering B, Rutkowski S, Doz F, Pizer B, Gustafsson G, Navajas A, et al. Hyperfractionated versusconventional radiotherapy followed by chemotherapy in standard-risk medulloblastoma: results from the randomized multicenter HIT-SIOP PNET 4 trial.J Clin Oncol. 2012;30:3187-3193.
Wolden SL, Dunkel IJ, Souweidane MM, Happersett L, Khakoo Y, Schupak,et al. Patterns of failure using a conformal radiation therapy tumor bed boost for medulloblastoma. J Clin Oncol. 2003;21:3079-83.
Merchant TE, Kun LE, Krasin MJ, Wallace D, Chintagumpala MM, Woo SY, et al. Multi-institution prospective trial of reduced-dose craniospinal irradiation (23.4 Gy) followed by conformal posterior fossa (36 Gy) and primary site irradiation (55.8 Gy) and dose-intensive chemotherapy for average-risk medulloblastoma. Int J Radiat Oncol Biol Phys. 2008;70:782-7.
Michalski J, Bell AA. Study evaluating limited target volume boost irradiation and reduced dose craniospinal radiotherapy (18 Gy) and chemotherapy in children with newly diagnosed standard risk medulloblastoma: A Phase III Double Randomized Trial. Children Oncology Group (ACNS0331). 2016 [cited 2016 Feb 15]. Available from: https://childrensoncologygroup.org/index.php/acns0331
Evans AE, Jenkin RD, Sposto R, Ortega JA, Wilson CB, Wara W,et al. The treatment of medulloblastoma results of a prospective randomized Trial of radiation therapy with and without CCNU, vincristine, and prednisone. Neurosurg. 1990; 72:572-582.
Tait DM, Thornton-Jonesb H, Bloom HJ, Lemerlec J, Morris-Jonesd P. Adjuvant chemotherapy for medulloblastoma: the first multi-centre control trial of the International Society of Paediatric Oncology. Eur J Cancer. 1990;26:464-9.
Kortmann RD, Kühl J, Timmermann B, Mittler U, Urban C, Budach V, et al. Postoperative neoadjuvant chemotherapy before radiotherapy as compared to immediate radiotherapy followed by maintenance chemotherapy in the treatment of medulloblastoma in childhood: results of the German prospective randomized trial HIT '91. Int J Radiat Oncol Biol Phys. 2000;46:269-79.
Tarbell NJ, Friedman H, Polkinghorn WR, Yock T, Zhou T, Chen Z, et al. High-risk medulloblastoma: a pediatric oncology group randomized trial of chemotherapy before or after radiation therapy (POG 9031). J Clin Oncol. 2013;31:2936-41
Taylor RE, Bailey CC, Robinson KJ, Weston CL, Walker DA, Ellison D, et al. Outcome for patients with metastatic (M2-3) medulloblastoma treated with SIOP/UKCCSG PNET-3 chemotherapy. Eur J Cancer. 2005;41:727-34
Gajjar A, Chintagumpala M, Ashley D, Kellie S, Kun LE, Merchant TE , et al. Risk-adapted craniospinal radiotherapy followed by high-dose chemotherapy and stem-cell rescue in children with newly diagnosed medulloblastoma (St Jude Medulloblastoma-96): long-term results from a prospective, multicentre trial. Lancet Oncol. 2006;7:813-20.
Olsen J, Black K. Efficacy of Carboplatin Administered Concomitantly With Radiation and Isotretinoin as a Pro-Apoptotic Agent in Other Than Average Risk Medulloblastoma/PNET Patients (ACNS0332). 2016 [cited 2016 Feb 15]. Available from: https://childrensoncologygroup.org/index.php/acns0332
Copeland DR, deMoor C, Moore BD 3rd, Ater JL. Neurocognitive development of children after a cerebellar tumor in infancy: A longitudinal study. J Clin Oncol. 1999;17:3476-86.
Duffner PK, Horowitz ME, Krischer JP, Burger PC, Cohen ME, Sanford RA, et al. The treatment of malignant brain tumors in infants and very young children: an update of the Pediatric Oncology Group experience. Neuro Oncol. 1999;1:152-61.
Rutkowski S, Bode U, Deinlein F, Ottensmeier H, Warmuth-Metz M, Soerensen N, et al. Treatment of early childhood medulloblastoma by postoperative chemotherapy alone. N Engl J Med. 2005;352:978-86.
The Thai Pediatric Oncology Group, The Thai Society of Hematology, National Health Security Office. National protocol for the treatment of childhood cancers 2014. Bangkok: mprint; 2014.
Xu H, Robinson GW, Huang J, Lim JY, Zhang H, Bass JK, et al. Common variants in ACYP2 influence susceptibility to cisplatin-induced hearing loss. Nature genetics. 2015:47;263-266
Sugie C, Shibamoto Y, Ayakawa S, Mimura M, Komai K, Ishii M, et al. Craniospinal Irradiation Using Helical Tomotherapy: Evaluation of Acute Toxicity and Dose Distribution. Technol Cancer Res Treat. 2011;10:187-195.
Lopez Guerra JL, Marrone I, Jaen J, Bruna M, Sole C, Sanchez-Reyes A, et al. Outcome and toxicity using helical tomotherapy for craniospinal irradiation in pediatric medulloblastoma. Clin Transl Oncol.2014;16:96-101.
Kunos CA, Dobbins DC, Kulasekere R, Latimer B, Kinsella TJ.Comparison of helical tomotherapy versus conventional radiation to deliver craniospinal radiation. Technol Cancer Res Treat. 2008;7:227-33.
St Clair WH, Adams JA, Bues M, Fullerton BC, La Shell S, Kooy HM, et al. 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. 2004;58:727-34.
Yuh GE, Loredo LN, Yonemoto LT, Bush DA, Shahnazi K, Preston W,et al. Reducing toxicity from craniospinal irradiation: using proton beams to treat medulloblastoma in young children. Cancer J. 2004;10:386-90.
Fossati P, Ricardi U, Orecchia R. Pediatric medulloblastoma: toxicity of current treatment and potential role of protontherapy. Cancer Treat Rev. 2009;35:79-96.
National Cancer Center Proton Therapy Center. Proton Therapy Clinical Cases Craniospinal Irradiation. 2015 [cited 2015 Nov 30]. Available from: http://www.nccproton.com
Chan AW, Tarbell NJ, Black PM, Louis DN, Frosch MP, Ancukiewicz M, et al.Adult medulloblastoma: prognostic factors and patterns of relapse.Neurosurgery. 2000;47:623.
Kadota RP, Mahoney DH, Doyle J, Duerst R, Friedman H, Holmes E, et al. Dose intensive melphalan and cyclophosphamide with autologous hematopoietic stem cells for recurrent medulloblastoma or germinoma. Pediatr Blood Cancer. 2008;51:675.
Dunkel IJ, Gardner SL, Garvin JH Jr, Goldman S, Shi W, Finlay JL. High-dose carboplatin, thiotepa, and etoposide with autologous stem cell rescue for patients with previously irradiated recurrent medulloblastoma.Neuro Oncol. 2010;12:297.
Carolyn RF, Jean PF, Roger ET. Central Nervous System Tumors in Children Chapter. In:Halperin EC, Perez CA, Brady LW, editors. Principle and Practice of Radiation Oncology. 6th edition. Philadephia:Lippincott Williams and Wilkins;2013.
Kun EL, MacDonald S, Tarbel NJ. Tumor in the posterior fossa and spinal canal. In:Halperin EC, Constine LS, Tarbel NJ, Kun EL, editors. Pediatric Radiation Oncology. 5thedition:Lippincott Williams and Wilkins;2010.
Jones BV. Neoplasm and Tumor like Lesions. In:Osborn AG, Blaser S, Salzman KL, Katzman GL, Provenzale J, editors. Diagnostic imaging brain. Canada:Amirsys;2004.
Monje J, Beachy PA, Fisher PG.Hedgehogs, flies, Wnts and MYCs: the time has come for many things in medulloblastoma.J Clin Oncol 2011;29:1395-8.
Northcott PA, Shih DJH, Peacock J, Garzia L, Morrissy AS, Zichner T, et al. Subgroup-specific structural variation across 1,000 medulloblastoma genomes. Nature 2012;488:49-56.
Gajjar A., Doyley TE. SJMB12: A Clinical and Molecular Risk-Directed Therapy for Newly Diagnosed Medulloblastoma/PNET. 2016 [cited 2016 Feb 15]. Available from: https://www.clinicaltrials.gov/ct2/ show/NCT01878617
Gaillard F.Medulloblastoma. 2015 [cited 2015 Dec 1]. Available from: http://radiopaedia.org/articles/ Medulloblastoma
Fouladi M, Gajjar A, Boyett JM, Walter AW, Thompson SJ, Merchant TE, et al. Comparison of CSF cytology and spinal magnetic resonance imaging in the detection of leptomeningeal disease in pediatric medulloblastoma or primitive neuroectodermal tumor. J Clin Oncol 1999;17:3234-3237.
Zeltzer PM, Boyett JM, Finlay JL, Albright AL, Rorke LB, Milstein JM, et al. Metastasis stage, adjuvant treatment, and residual tumor are prognostic factors for medulloblastoma in children: conclusions from the children's cancer group 921 Randomized Phase III Study. J Clin Oncol 1999;17:832-45.
Bailey P, Cushing H. Medulloblastoma cerebelli. A common type of midcerebellar glioma of childhood. Arch Neurol Neurosurg Psychiatry.1925;14:192–224.
Rieken S, Mohr A, Habermehl D, Welzel T, Lindel K, Witt O, et al. Outcome and prognostic factors of radiation therapy for medulloblastoma. Int J Radiat Oncol Biol Phys. 2011;81:e7-e13.
Taylor RE, Bailey CC, Robinson K, Weston CL, Ellison D, Ironside J, et al. Results of a randomized study of preradiation chemotherapy versusradiotherapy alone for nonmetastatic medulloblastoma: The International Society of Paediatric Oncology/United Kingdom Children's Cancer Study Group PNET-3 Study. J Clin Oncol. 2003;21:1581-91.
Kieffer-Renaux V, Bulteau C, Grill J, Kalifa C, Viguier D, Jambaque I.Patterns of neuropsychological deficits in children with medulloblastoma according to craniospatial irradiation doses. Dev Med Child Neurol. 2000;42:741-5.
Silber JH, Radcliffe J, Peckham V, Perilongo G, Kishnani P, Fridman M, et al. Whole-brain irradiation and decline in intelligence: the influence of dose and age on IQ score. J Clin Oncol. 1992;10:1390-6.
Thomas PR, Deutsch M, Kepner JL, Boyett JM, Krischer J, Aronin P, et al. Low-stage medulloblastoma: final analysis of trial comparing standard-dose with reduced-dose neuraxis irradiation. J Clin Oncol. 2000;18:3004.
Bailey CC, Gnekow A, Wellek S, Jones M, Round C, Brown J, et al. Prospective randomised trial of chemotherapy given before radiotherapy in childhood medulloblastoma. International Society of Paediatric Oncology (SIOP) and the (German) Society of Paediatric Oncology. Med Pediatr Onc. 1995; 25:166-78.
Packer RJ, Goldwein J, Nicholson HS, Vezina LG, Allen JC, Ris MD,et al. Treatment of children with medulloblastomas with reduced-dose craniospinal radiation therapy and adjuvant chemotherapy: A Children's Cancer Group Study. J Clin Oncol. 1999;17:2127-36.
Mulhern RK, Kepner JL, Thomas PR, Armstrong FD, Friedman HS, Kun LE. Neuropsychologic functioning of survivors of childhood medulloblastoma randomized to receive conventional or reduced-dose craniospinal irradiation: a Pediatric Oncology Group study. J Clin Oncol. 1998;16:1723-1728
Ris MD, Packer R, Goldwein J, Wallace DJ, Boyett JM. Intellectual outcome after reduced-dose radiation therapy plus adjuvant chemotherapy for medulloblastoma: A Children’s Cancer Group Study. J Clin Oncol. 2001;19:3470-3476.
Packer RJ, Gajjar A, Vezina G, Adams LR, Burger PC, Patricia L,et al. Phase III study of craniospinal radiation therapy followed by adjuvant chemotherapy for newly diagnosed average-risk medulloblastoma. J Clin Oncol. 2006;24:4202-8.
Lannering B, Rutkowski S, Doz F, Pizer B, Gustafsson G, Navajas A, et al. Hyperfractionated versusconventional radiotherapy followed by chemotherapy in standard-risk medulloblastoma: results from the randomized multicenter HIT-SIOP PNET 4 trial.J Clin Oncol. 2012;30:3187-3193.
Wolden SL, Dunkel IJ, Souweidane MM, Happersett L, Khakoo Y, Schupak,et al. Patterns of failure using a conformal radiation therapy tumor bed boost for medulloblastoma. J Clin Oncol. 2003;21:3079-83.
Merchant TE, Kun LE, Krasin MJ, Wallace D, Chintagumpala MM, Woo SY, et al. Multi-institution prospective trial of reduced-dose craniospinal irradiation (23.4 Gy) followed by conformal posterior fossa (36 Gy) and primary site irradiation (55.8 Gy) and dose-intensive chemotherapy for average-risk medulloblastoma. Int J Radiat Oncol Biol Phys. 2008;70:782-7.
Michalski J, Bell AA. Study evaluating limited target volume boost irradiation and reduced dose craniospinal radiotherapy (18 Gy) and chemotherapy in children with newly diagnosed standard risk medulloblastoma: A Phase III Double Randomized Trial. Children Oncology Group (ACNS0331). 2016 [cited 2016 Feb 15]. Available from: https://childrensoncologygroup.org/index.php/acns0331
Evans AE, Jenkin RD, Sposto R, Ortega JA, Wilson CB, Wara W,et al. The treatment of medulloblastoma results of a prospective randomized Trial of radiation therapy with and without CCNU, vincristine, and prednisone. Neurosurg. 1990; 72:572-582.
Tait DM, Thornton-Jonesb H, Bloom HJ, Lemerlec J, Morris-Jonesd P. Adjuvant chemotherapy for medulloblastoma: the first multi-centre control trial of the International Society of Paediatric Oncology. Eur J Cancer. 1990;26:464-9.
Kortmann RD, Kühl J, Timmermann B, Mittler U, Urban C, Budach V, et al. Postoperative neoadjuvant chemotherapy before radiotherapy as compared to immediate radiotherapy followed by maintenance chemotherapy in the treatment of medulloblastoma in childhood: results of the German prospective randomized trial HIT '91. Int J Radiat Oncol Biol Phys. 2000;46:269-79.
Tarbell NJ, Friedman H, Polkinghorn WR, Yock T, Zhou T, Chen Z, et al. High-risk medulloblastoma: a pediatric oncology group randomized trial of chemotherapy before or after radiation therapy (POG 9031). J Clin Oncol. 2013;31:2936-41
Taylor RE, Bailey CC, Robinson KJ, Weston CL, Walker DA, Ellison D, et al. Outcome for patients with metastatic (M2-3) medulloblastoma treated with SIOP/UKCCSG PNET-3 chemotherapy. Eur J Cancer. 2005;41:727-34
Gajjar A, Chintagumpala M, Ashley D, Kellie S, Kun LE, Merchant TE , et al. Risk-adapted craniospinal radiotherapy followed by high-dose chemotherapy and stem-cell rescue in children with newly diagnosed medulloblastoma (St Jude Medulloblastoma-96): long-term results from a prospective, multicentre trial. Lancet Oncol. 2006;7:813-20.
Olsen J, Black K. Efficacy of Carboplatin Administered Concomitantly With Radiation and Isotretinoin as a Pro-Apoptotic Agent in Other Than Average Risk Medulloblastoma/PNET Patients (ACNS0332). 2016 [cited 2016 Feb 15]. Available from: https://childrensoncologygroup.org/index.php/acns0332
Copeland DR, deMoor C, Moore BD 3rd, Ater JL. Neurocognitive development of children after a cerebellar tumor in infancy: A longitudinal study. J Clin Oncol. 1999;17:3476-86.
Duffner PK, Horowitz ME, Krischer JP, Burger PC, Cohen ME, Sanford RA, et al. The treatment of malignant brain tumors in infants and very young children: an update of the Pediatric Oncology Group experience. Neuro Oncol. 1999;1:152-61.
Rutkowski S, Bode U, Deinlein F, Ottensmeier H, Warmuth-Metz M, Soerensen N, et al. Treatment of early childhood medulloblastoma by postoperative chemotherapy alone. N Engl J Med. 2005;352:978-86.
The Thai Pediatric Oncology Group, The Thai Society of Hematology, National Health Security Office. National protocol for the treatment of childhood cancers 2014. Bangkok: mprint; 2014.
Xu H, Robinson GW, Huang J, Lim JY, Zhang H, Bass JK, et al. Common variants in ACYP2 influence susceptibility to cisplatin-induced hearing loss. Nature genetics. 2015:47;263-266
Sugie C, Shibamoto Y, Ayakawa S, Mimura M, Komai K, Ishii M, et al. Craniospinal Irradiation Using Helical Tomotherapy: Evaluation of Acute Toxicity and Dose Distribution. Technol Cancer Res Treat. 2011;10:187-195.
Lopez Guerra JL, Marrone I, Jaen J, Bruna M, Sole C, Sanchez-Reyes A, et al. Outcome and toxicity using helical tomotherapy for craniospinal irradiation in pediatric medulloblastoma. Clin Transl Oncol.2014;16:96-101.
Kunos CA, Dobbins DC, Kulasekere R, Latimer B, Kinsella TJ.Comparison of helical tomotherapy versus conventional radiation to deliver craniospinal radiation. Technol Cancer Res Treat. 2008;7:227-33.
St Clair WH, Adams JA, Bues M, Fullerton BC, La Shell S, Kooy HM, et al. 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. 2004;58:727-34.
Yuh GE, Loredo LN, Yonemoto LT, Bush DA, Shahnazi K, Preston W,et al. Reducing toxicity from craniospinal irradiation: using proton beams to treat medulloblastoma in young children. Cancer J. 2004;10:386-90.
Fossati P, Ricardi U, Orecchia R. Pediatric medulloblastoma: toxicity of current treatment and potential role of protontherapy. Cancer Treat Rev. 2009;35:79-96.
National Cancer Center Proton Therapy Center. Proton Therapy Clinical Cases Craniospinal Irradiation. 2015 [cited 2015 Nov 30]. Available from: http://www.nccproton.com
Chan AW, Tarbell NJ, Black PM, Louis DN, Frosch MP, Ancukiewicz M, et al.Adult medulloblastoma: prognostic factors and patterns of relapse.Neurosurgery. 2000;47:623.
Kadota RP, Mahoney DH, Doyle J, Duerst R, Friedman H, Holmes E, et al. Dose intensive melphalan and cyclophosphamide with autologous hematopoietic stem cells for recurrent medulloblastoma or germinoma. Pediatr Blood Cancer. 2008;51:675.
Dunkel IJ, Gardner SL, Garvin JH Jr, Goldman S, Shi W, Finlay JL. High-dose carboplatin, thiotepa, and etoposide with autologous stem cell rescue for patients with previously irradiated recurrent medulloblastoma.Neuro Oncol. 2010;12:297.
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2016-06-30
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นันทวิทยา ช. Medulloblastoma in Children. J Thai Assn of Radiat Oncol [Internet]. 2016 Jun. 30 [cited 2024 Jul. 3];22(1):62-78. Available from: https://he01.tci-thaijo.org/index.php/jtaro/article/view/203084
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บทความที่ได้รับการตีพิมพ์เป็นลิขสิทธิ์ของวารสารมะเร็งวิวัฒน์ ข้อความที่ปรากฏในบทความแต่ละเรื่องในวารสารวิชาการเล่มนี้เป็นความคิดเห็นส่วนตัวของผู้เขียนแต่ละท่านไม่เกี่ยวข้องกับ และบุคคลากรท่านอื่น ๆ ใน สมาคมฯ แต่อย่างใด ความรับผิดชอบองค์ประกอบทั้งหมดของบทความแต่ละเรื่องเป็นของผู้เขียนแต่ละท่าน หากมีความผิดพลาดใดๆ ผู้เขียนแต่ละท่านจะรับผิดชอบบทความของตนเองแต่ผู้เดียว
