• Aaron P Brown, Christian L Barney, David R Grosshans, Mary Frances McAleer, John F de Groot, Vinay K Puduvalli, Susan L Tucker, Cody N Crawford, Meena Khan, Soumen Khatua, Mark R Gilbert, Paul D Brown, and Anita Mahajan.
• Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
• Int. J. Radiat. Oncol. Biol. Phys. 2013 Jun 1; 86 (2): 277-84.

PurposeEfficacy and acute toxicity of proton craniospinal irradiation (p-CSI) were compared with conventional photon CSI (x-CSI) for adults with medulloblastoma.Methods And MaterialsForty adult medulloblastoma patients treated with x-CSI (n=21) or p-CSI (n=19) at the University of Texas MD Anderson Cancer Center from 2003 to 2011 were retrospectively reviewed. Median CSI and total doses were 30.6 and 54 Gy, respectively. The median follow-up was 57 months (range 4-103) for x-CSI patients and 26 months (range 11-63) for p-CSI.Resultsp-CSI patients lost less weight than x-CSI patients (1.2% vs 5.8%; P=.004), and less p-CSI patients had >5% weight loss compared with x-CSI (16% vs 64%; P=.004). p-CSI patients experienced less grade 2 nausea and vomiting compared with x-CSI (26% vs 71%; P=.004). Patients treated with x-CSI were more likely to have medical management of esophagitis than p-CSI patients (57% vs 5%, P<.001). p-CSI patients had a smaller reduction in peripheral white blood cells, hemoglobin, and platelets compared with x-CSI (white blood cells 46% vs 55%, P=.04; hemoglobin 88% vs 97%, P=.009; platelets 48% vs 65%, P=.05). Mean vertebral doses were significantly associated with reductions in blood counts.ConclusionsThis report is the first analysis of clinical outcomes for adult medulloblastoma patients treated with p-CSI. Patients treated with p-CSI experienced less treatment-related morbidity including fewer acute gastrointestinal and hematologic toxicities.Copyright © 2013 Elsevier Inc. All rights reserved.

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