Study of SBRT Efficacy on Intra and Extra -Cranial Tumors or Metastasis in Pediatrics Population (SBRT Pediatrics)

Inclusion Criteria

• •18 months ≤ age ≤ 20 years
• •Malignant primary tumor, histologically or cytologically proven
• •Systemic disease under control or with slow evolution
• •Written indication of SBRT according to local pediatrics meeting and national Radiotherapy (RT) web conference
• •Performance Status ≤ 2 according to Eastern Cooperative Oncology Group (ECOG)
• •Sites
• •* Brain metastasis (≤ 3 on MRI) not suitable for surgery, without hemorrhage, less than 3 cm each, not in the brain stem
• •* Primary or secondary spinal/para spinal metastasis (≤ 3), not suitable for surgery or with a non operable macroscopic residue, less than 5 cm
• •Concomitant chemotherapy
• •No evaluable target (except for completely resected ependymomas)
• •Pregnancy
• •Follow-up impossible
• •IN ADDITION FOR RELAPSING EPENDYMOMAS:
• •Metastatic patient at diagnosis and/or at relapse
• •Complete remission never obtained
• •NON-RANDOMIZATION DOSIMETRIC CRITERIA (ONLY FOR EPENDYMOMA)
• •Cumulative doses to brain stem ≥ 115 Gy
• •Tumor volume at relapse ≥ 30 cm3
• •Primary RT dose + Re-irradiation dose more than 112 Gy
• •Cumulative dose to the chiasma \> 54 Gy
• •Cumulative dose to any point of the brain \> 115 Gy