Craniospinal irradiation remains an important technique in the management of malignancies of the central nervous system. It is technically demanding, with potential for treatment field overlap or gaps to yield unacceptable dosimetric heterogeneity. A method to accurately simulate and verify the three-field junction is described. We use a comfortable supine position to minimize patient movement....

BACKGROUND AND PURPOSE A decline in intrahemispheric cerebral white matter volume in children treated for brain tumors with cranial irradiation has been well documented. It was hypothesized that the development of the corpus callosum, the largest white matter commissure of the brain, would also be adversely affected after treatment with cranial irradiation in pediatric patients treated for medu...

Choroid plexus papilloma (CPP) is a low-grade neoplasm of the choroid plexus that typically occurs in childhood and comprises under 1% of adult brain tumors. In this article, we report our experience delivering craniospinal irradiation (CSI) to a highly unusual case of disseminated CPP in an adult patient 8 years after an initial near total resection. The patient remains free of disease progres...

We present a technique for planning and verification of craniospinal treatment with the patient in the supine position. Treatment delivery and verification is streamlined through the use of modern imaging techniques. Treatments use two lateral brain fields abutted to a single or pair of posterior spine fields. Treatment delivery is simplified by aligning all isocenters in the anterior-posterior...

BACKGROUND Cranial reirradiation is clinically appropriate in some cases but cumulative radiation dose to critical normal structures remains a practical concern. The authors developed a simple technique in 3D conformal proton craniospinal irradiation (CSI) to block organs at risk (OAR) while minimizing underdosing of adjacent target brain tissue. METHODS Two clinical cases illustrate the use ...

Aim To evaluate final height in a cohort of Dutch childhood cancer survivors (CCS) and assess possible determinants of final height, including height at diagnosis. Patients and Methods We calculated standard deviation scores (SDS) for height at initial cancer diagnosis and height in adulthood in a cohort of 573 CCS. Multivariable regression analyses were performed to estimate the influence of d...