Case Report - Repeat Craniospinal Irradiation for Medulloblastoma

Medulloblastoma (MB) is the most common malignant central nervous system (CNS) tumour in children.Risk profile guides multidisciplinary intervention which includes surgery, radiation and chemotherapy.The clinical benefits of re-irradiation for relapsed disease have been described but seldom undertaken in fear of exceeding the tolerance of important organs at risk.We present a case of recurrent medulloblastoma in a 37-yearold patient who was originally diagnosed and treated 29 years prior.We treated her with chemotherapy followed by re-irradiation of the craniospinal axis and consider benefits of this approach versus potentially lifethreatening toxicity.VMAT was used to optimize conformity, homogeneity and minimize dose to surrounding organs at risk.We discuss the rationale of this management approach in context of the literature.