Low-dose radiation inferior to standard-dose radiation in children with medulloblastoma

A Children’s Oncology Group (COG) study has evaluated the impact of low-dose radiation therapy in children with medulloblastoma.

Standard therapy for patients with medulloblastoma aged >3 years consists of craniospinal radiation (CSRT) plus chemotherapy. However, this approach is associated with radiation-related neurocognitive decline and poor quality of life.

The COG trial was conducted in part to determine whether lower doses of CSRT would reduce neurocognitive decline without compromising event-free survival (EFS) and overall survival (OS).

A total of 226 patients aged 3 to 7 years were randomized to low-dose CSRT (18.0 Gy) or standard-dose CSRT (23.4 Gy). In a post-hoc analysis, the impact of molecular subtype (WNT, SHH, Group 3, or Group 4) on survival outcomes was also assessed.