{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T04:23:27Z","timestamp":1791174207204,"version":"4.1.0"},"reference-count":25,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2005,1,7]],"date-time":"2005-01-07T00:00:00Z","timestamp":1105056000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2005,2,15]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Most medulloblastomas express high levels of somatostatin type 2 receptors (sst2). DOTA<jats:sup>0<\/jats:sup>\u2010D\u2010Phe<jats:sup>1<\/jats:sup>\u2010Tyr<jats:sup>3<\/jats:sup>\u2010octreotide (DOTATOC) specifically binds sst2 in the low nanomolar range. The cytotoxic effect is mediated by the chelated, \u03b2\u2010emitting, metallic radionuclide Yttrium 90 (<jats:sup>90<\/jats:sup>Y). The authors applied this innovative treatment option in a boy age 8 years who presented with a recurrent medulloblastoma of the cauda equina: a prognostically poor condition. Targeted radiotherapy was administered to treat minimal sst2\u2010expressing tumor remnants, which persisted despite conventional and high\u2010dose chemotherapy and intercurrent resection of the lesion.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>A medulloblastoma arising from the floor of the fourth ventricle had been removed surgically; then, the patient was treated with standard adjuvant chemotherapy and craniospinal irradiation according to the prospective HIT '91 protocol. Complete remission was achieved for 20 months, when a drop metastasis of the cauda equina manifested with sensorimotor lumbosacral deficits and urinary incontinence. After four cycles of neoadjuvant chemotherapy (which consisted of combined ifosfamide, carboplatinum and etoposide), two cycles of high\u2010dose chemotherapy and autologous stem cell transplantation were performed; in between, the responding residual tumor within the lumbosacral nerve fibers was microscopically removed. Thereafter, an Indium\u2010111\u2010DOTATOC test injection indicated sst2\u2010expressing tumor remnants within the cauda equina. Con\u2010 sequently, 4 cycles of [<jats:sup>90<\/jats:sup>Y]\u2010DOTATOC (4 \u00d7 562.5 megabecquerels) were injected directly into the cerebrospinal fluid in monthly intervals.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>The consolidating intrathecal brachytherapy using [<jats:sup>90<\/jats:sup>Y]\u2010DOTATOC was tolerated well. A complete remission was achieved for a 3\u2010year period. The only remaining deficit was urinary incontinence.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Intrathecal administration of targeted radiopeptide brachytherapy in combination with conventional and high\u2010dose chemotherapy and surgical removal represents a promising new option to treat recurrent medulloblastoma and should be explored further. Cancer 2005. \u00a9 2005 American Cancer Society.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.20822","type":"journal-article","created":{"date-parts":[[2005,1,7]],"date-time":"2005-01-07T18:25:46Z","timestamp":1105122346000},"page":"869-873","source":"Crossref","is-referenced-by-count":25,"title":["Three\u2010year recurrence\u2010free survival in a patient with recurrent medulloblastoma after resection, high\u2010dose chemotherapy, and intrathecal Yttrium\u201090\u2010labeled DOTA<sup>0<\/sup>\u2010D\u2010Phe<sup>1<\/sup>\u2010Tyr<sup>3<\/sup>\u2010octreotide radiopeptide brachytherapy"],"prefix":"10.1002","volume":"103","author":[{"given":"Daniel","family":"Beutler","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierino","family":"Avoledo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean\u2010Claude","family":"Reubi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helmut 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