Author/Editor		Šlampa, Pavel; Seneklova, Zuzana; Simicek, Jiri; Soumarova, Renata; Burkon, Petr; Burianova, Ludmila
Title		The technique of craniospinal irradiation of paediatric patients in supine position
Translated title		Obsevanje kraniospinalnega predela pri otrocih, ki ležijo na hrbtu
Type		članek
Source		Radiol Oncol
Vol. and No.		Letnik 35, št. 4
Publication year		2001
Volume		str. 267-72
Language		eng
Abstract		Background. Postoperative radiation therapy has significant impact on local control and overall survival of paediatric patients with brain tumours but an irradiated volume is often a controversial issue. Our aim was to describe a new technique of craniospinal irradiation as a postoperative treatment in patients with the risk of relapse of brain tumours as well as to estimate the side effects of such craniospinal irradiation. Patients and methods. In the last 4 years, 17 paediatric patients under 15 years of age with medulloblastoma (8) ependymoma (6) and glioblastoma (3) received postoperative craniospinal axis radiotherapy by a new technique developed in our departments. This technique is based on irradiation in supine position with the use of asymmetric jaws of the linear accelerator. Results. Radiotherapy was well tolerated and dose-reduction was not needed in any case. Skin reactions were mild in all patients. The gastrointestinal and haematological toxicity was mild to moderate (WHO grade 1-II). Conclusion. The proposed new technique of craniospinal irradiation is advantageous in terms of side effects and could be recommended to be widely used. Craniospinal irradiation in supine position is an alternative method to the treatment in prone position. The evaluation of the effectiveness was limited by a short follow-up interval.
Summary		Izhodišča. S pooperativnim obsevanjem lahko večkrat preprečimo lokalno ponovitev bolezni in podaljšamo preživetje otrok z možganskimo tumorji. V članku smo želeli predstaviti nov načn pooperativnega obsevanja kraniospinalnega predela pri otrocih, ki so bili operirani zaradi možganskega tumorja; želeli pa smo tudi opisati morebitne stranske učinke takšnega zdravljenja. Bolniki in metode. V štirih letih smo pooperativno obsevali kraniospinalno področje pri 17 otrocih, starih manj kot 15 let. 8 jih je imelo meduloblastom, 6 ependimom in 3 glioblastom. Obsevali smo jih z novim načinom, ki smo ga razvili na našem oddelku. Bolniki so ležali na hrbtu in ne na trebuhu, kakor je sicer običajno. Pri obsevanju smo uporabili nesimetrične čeljusti linearnega pospeševalnika. Rezultati. Bolniki so radioterapijo dobro prenašali, pri nobenem ni bilo potrebno zmanjševati obsevalne doze. Pri vseh bolnikih so bile kožne reakcije blage. Prav tako so bili gastrointestinalni in hematološki učinki blagi ali zmerni (stopnje I ali II po klasifikaciji SZO). Zaključlti. Nov način obsevanja kraniospinalnega področja bolnika ležečega na hrbtu povzroča malo stranskih učinkov, zato ga priporočamo. Je alternativna metoda glede na običajno obsevanje, ko leži bolnik na trebuhu. Ker je opazovana doba naših bolnikov kratka, je oceana učinkovitosti takšnega obsevanja (vpliv na lokalno ponovitev bolezni in preživetje) še nezanesljiva.
Descriptors		BRAIN NEOPLASMS RADIOTHERAPY SUPINE POSITION CHILD