Trial reportJournal of clinical oncology : official journal of the American Society of Clinical Oncology2021
Children's Oncology Group Phase III Trial of Reduced-Dose and Reduced-Volume Radiotherapy With Chemotherapy for Newly Diagnosed Average-Risk Medulloblastoma.
Trial report in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00085735 (A Study Evaluating Limited Target Volume Boost Irradiation and Reduced Dose Craniospinal Radiotherapy), which is not on this map. Cited by 123 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Study Evaluating Limited Target Volume Boost Irradiation and Reduced Dose Craniospinal Radiotherapy (18.00 Gy) and Chemotherapy in Children With Newly Diagnosed Standard Risk Medulloblastoma: A Phase III Double Randomized Trial
Who cites it
123 citing papers in PubMed, 4 syntheses or guidelines pooled it, 189 citations in OpenAlex.
- Reporting of Rurality, Deprivation, and Socioeconomic Characteristics in Cancer Clinical Trials: A Systematic Review.JAMA network open · 2026Pooled it
- The Medulloblastoma Meta-Analysis Portal Enables Integrative Exploration of Clinical and Genomic Data from Patients.Cancer research · 2025Pooled it
- Neurocognitive outcomes in pediatric brain tumors after treatment with proton versus photon radiation: a systematic review and meta-analysis.World journal of pediatrics : WJP · 2023Pooled it
- Questions and answers in the management of children with medulloblastoma over the time. How did we get here? A systematic review.Frontiers in oncology · 2023Pooled it
- Phase 3 randomized trial of high-dose methotrexate for young children with high-risk embryonal brain tumors: A report from the Children's Oncology Group.Neuro-oncology · 2025Trial
- Long-term outcomes of pediatric medulloblastoma before routine molecular classification: a 20-year single-center cohort study.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2026Article
- AOSNP-ADAPTR resource level-based recommendations on practical diagnostic strategies for medulloblastomas and other embryonal tumors.Brain pathology (Zurich, Switzerland) · 2026Article
- Age-Dependent Toxicity Patterns in Medulloblastoma: A Comparative Analysis of Treatment-Related Adverse Events Between Pediatric and Adult Populations.Journal of clinical medicine · 2026Article
- Surgical resection in medulloblastoma: a crossroads in the molecular era.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2026Review
- From developmental origins to relapse: molecular and therapeutic insights in medulloblastoma.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2026Review
- Cumulative dose of chemotherapy and survival outcomes in children with average-risk medulloblastoma treated on Children's Oncology Group study ACNS0331.Neuro-oncology · 2026Article
- Impact of salvage treatment for recurrent medulloblastoma in previously irradiated patients (KROG 23-02): A multi-institutional retrospective study.Clinical and translational radiation oncology · 2026Article
- Women in neurosurgical oncology: Mapping the milestones and shaping the future.Neuro-oncology advances · 2026Review
- Meningeal-tumor interactions define distinct modes of leptomeningeal colonization in Group 3 medulloblastoma.Acta neuropathologica communications · 2026Article
- Longitudinal cortical thickness changes in children with posterior fossa tumors.Neuro-oncology practice · 2026Article
- Developmental determinants of male bias in medulloblastoma.bioRxiv : the preprint server for biology · 2026Article
- Medulloblastoma in Adolescents and Young Adults: Molecular Subgroups, Prognostic Biomarkers, and Age-Specific Therapeutic Challenges.Current issues in molecular biology · 2026Review
- A feasibility study of functional preservation in craniospinal irradiation with photon for pediatric medulloblastoma.Journal of applied clinical medical physics · 2026Article
- High-dose chemotherapy and craniospinal irradiation-sparing approach for WNT medulloblastoma of early childhood.Journal of neuro-oncology · 2026Article
- The potential and risks of FLASH radiotherapy in pediatric patients.Neuro-oncology pediatrics · 2026Review
63 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
28 authors at 15 institutions in 1 country.
Funding
Abstract
purposeChildren with average-risk medulloblastoma (MB) experience survival rates of ≥ 80% at the expense of adverse consequences of treatment. Efforts to mitigate these effects include deintensification of craniospinal irradiation (CSI) dose and volume.
methodsACNS0331 (ClinicalTrials.gov identifier: NCT00085735) randomly assigned patients age 3-21 years with average-risk MB to receive posterior fossa radiation therapy (PFRT) or involved field radiation therapy (IFRT) following CSI. Young children (3-7 years) were also randomly assigned to receive standard-dose CSI (SDCSI; 23.4 Gy) or low-dose CSI (LDCSI; 18 Gy). Post hoc molecular classification and mutational analysis contextualized outcomes according to known biologic subgroups (Wingless, Sonic Hedgehog, group 3, and group 4) and genetic biomarkers. Neurocognitive changes and ototoxicity were monitored over time.
resultsFive hundred forty-nine patients were enrolled on study, of which 464 were eligible and evaluable to compare PFRT versus IFRT and 226 for SDCSI versus LDCSI. The five-year event-free survival (EFS) was 82.5% (95% CI, 77.2 to 87.8) and 80.5% (95% CI, 75.2 to 85.8) for the IFRT and PFRT regimens, respectively, and 71.4% (95% CI, 62.8 to 80) and 82.9% (95% CI, 75.6 to 90.2) for the LDCSI and SDCSI regimens, respectively. IFRT was not inferior to PFRT (hazard ratio, 0.97; 94% upper CI, 1.32). LDCSI was inferior to SDCSI (hazard ratio, 1.67%; 80% upper CI, 2.10). Improved EFS was observed in patients with Sonic Hedgehog MB who were randomly assigned to the IFRT arm (
conclusionReducing the radiation boost volume in average-risk MB is safe and does not compromise survival. Reducing CSI dose in young children with average-risk MB results in inferior outcomes, possibly in a subgroup-dependent manner, but is associated with better neurocognitive outcome. Molecularly informed patient selection warrants further exploration for children with MB to be considered for late-effect sparing approaches.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.