proton beam radiation therapy in treating young patients who have undergone biopsy or surgery for medulloblastoma or pineoblastoma

Conditions: Brain and Central Nervous System Tumors; Long-term Effects Secondary to Cancer Therapy in Children

Summary: rationale: specialized radiation therapy that delivers radiation directly to the area where a tumor was surgically removed may kill any remaining tumor cells and cause less damage to normal tissue. purpose: this phase ii trial is studying how well proton beam radiation therapy works in treating young patients who have undergone biopsy or surgery for medulloblastoma or pineoblastoma.

objectives: * determine the 3-year incidence and severity of ototoxicity in young patients with medulloblastoma or pineoblastoma treated with adjuvant proton beam craniospinal and posterior fossa radiotherapy. * determine the incidence of primary hypothyroidism and other endocrine dysfunction (neuroendocrine and end organ) in patients treated with this regimen. * determine the incidence and severity of neurocognitive abnormalities in patients treated with this regimen. * determine the acute side effects of this regimen, including esophagitis, upper and lower gastrointestinal tract disease, and weight loss, in these patients. * determine the 3-year progression-free survival rate of patients treated with this regimen. outline: patients are stratified according to risk (standard vs high). patients receive proton beam craniospinal and posterior fossa radiotherapy once daily 5 days a week for 6-8 weeks\*. note: \*unless otherwise specified by a co-existing protocol. patients undergo neurocognitive evaluation at baseline or within 3 months after completion of radiotherapy and then at 1, 3, and 5 years. patients also undergo endocrine evaluation at baseline and then annually for 5 years; and audiology evaluation at baseline, before each course of cisplatin-based chemotherapy (if receiving this), and then annually for 5 years. after completion of study treatment, patients are followed every 3-6 months for 2-5 years. projected accrual: a total of 60 patients will be accrued for this study.

Eligibility criteria:
disease characteristics: * histologically confirmed medulloblastoma or pineoblastoma * standard-risk or high-risk disease * must have undergone biopsy or attempted surgical resection of the tumor within the past 35 days * requires craniospinal irradiation patient characteristics: age * 3 to 21 performance status * not specified life expectancy * not specified hematopoietic * not specified hepatic * not specified renal * not specified other * not pregnant or nursing * negative pregnancy test * fertile patients must use effective contraception prior concurrent therapy: biologic therapy * not specified chemotherapy * no more than 1 prior chemotherapy regimen * no prior iv or intrathecal methotrexate * no prior intrathecal thiotepa * concurrent cisplatin-based chemotherapy, including chemotherapy administered on another study, allowed endocrine therapy * not specified radiotherapy * no prior radiotherapy surgery * see disease characteristics

Keywords: long-term effects secondary to cancer therapy in children untreated childhood medulloblastoma untreated childhood pineoblastoma