Radiotherapy in pediatric medulloblastoma: Quality assessment of Pediatric Oncology Group Trial 9031

Raymond Miralbell, T. J. Fitzgerald, Fran Laurie, Sandy Kessel, Arvin Glicksman, Henry S. Friedman, Marcia Urie, James L. Kepner, Tianni Zhou, Zhengjia Chen, Pat Barnes, Larry Kun, Nancy J. Tarbell

Research output: Contribution to journalArticlepeer-review

41 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)1325-1330
Number of pages6
JournalInternational Journal of Radiation Oncology Biology Physics
Issue number5
StatePublished - Apr 1 2006


  • Medulloblastoma
  • Pediatric Oncology Group
  • Quality assurance
  • Radiotherapy

ASJC Scopus subject areas

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research


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