Technical aspects in cerebrospinal irradiation.

BACKGROUND: Craniospinal irradiation (CSI) is commonly used for medulloblastoma patients and some others; for example, those with ependymoma. It is a complex technique where accuracy of field placement and choice of irradiation source and energy can play a major role in determining success or failure. PROCEDURE: A literature review of the techniques used and reported by treatment centers was undertaken.
RESULTS: Great variability was found in methods and practices. This is striking because many hospitals treat fewer than five patients per year.
CONCLUSION: Standardized techniques with strict central review for quality control before therapy is initiated should become the norm. Standardization is especially important when clinical trials are planned. Valid outcome data depend on CSI uniformity. Copyright 2004 Wiley-Liss, Inc.