Advantage of protons compared to conventional X-ray or IMRT in the treatment of a pediatric patient with medulloblastoma

W. H. St. Clair, J. A. Adams, M. Bues, B. C. Fullerton, Sean La Shell, H. M. Kooy, J. S. Loeffler, N. J. Tarbell

Research output: Contribution to journalArticlepeer-review

311 Scopus citations


Purpose: To compare treatment plans from standard photon therapy to intensity modulated X-rays (IMRT) and protons for craniospinal axis irradiation and posterior fossa boost in a patient with medulloblastoma. Methods: Proton planning was accomplished using an in-house 3D planning system. IMRT plans were developed using the KonRad treatment planning system with 6-MV photons. Results: Substantial normal-tissue dose sparing was realized with IMRT and proton treatment of the posterior fossa and spinal column. For example, the dose to 90% of the cochlea was reduced from 101.2% of the prescribed posterior fossa boost dose from conventional X-rays to 33.4% and 2.4% from IMRT and protons, respectively. Dose to 50% of the heart volume was reduced from 72.2% for conventional X-rays to 29.5% for IMRT and 0.5% for protons. Long-term toxicity with emphasis on hearing and endocrine and cardiac function should be substantially improved secondary to nontarget tissue sparing achieved with protons. Conclusion: The present study clearly demonstrates the advantage of conformal radiation methods for the treatment of posterior fossa and spinal column in children with medulloblastoma, when compared to conventional X-rays. Of the two conformal treatment methods evaluated, protons were found to be superior to IMRT.

Original languageEnglish
Pages (from-to)727-734
Number of pages8
JournalInternational Journal of Radiation Oncology Biology Physics
Issue number3
StatePublished - Mar 2004

Bibliographical note

Funding Information:
Supported in part by a grant (PO1-CA 21239) from the National Cancer Institute and National Institutes of Health.


  • IMRT
  • Medulloblastoma
  • Proton

ASJC Scopus subject areas

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


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