A Trial Of Radioimmunotherapy, Reduced-Dose External Beam Craniospinal Radiation Therapy With IMRT Boost, And Chemotherapy For Patients With Standard-Risk Medulloblastoma

Inclusion Criteria

INCLUSION CRITERIA:

- Patients must have histologic proof of medulloblastoma reviewed by the Department of
Pathology at the Memorial Sloan-Kettering Cancer Center.

- Patients must begin study prescribed therapy within 42 days of neurosurgical
resection of the tumor

- Age ≥ 3-years-old. Post-operative head MRI must confirm ≤ 1.5 cm2 of residual tumor
is present.

- Head and spine MRI and lumbar CSF cytology must not show any definitive evidence of
leptomeningeal dissemination (Chang stage M-0).

- Examinations evaluating extra-neural sites will not be mandated, but any performed
for clinical indications must be free of metastatic disease.

- No prior RT or chemotherapy for the medulloblastoma is permitted Patients must have
adequate CSF flow (defined as lack of compartmentalization) on an 111-Indium DTPA
flow study.

- Patients must have adequate organ function as defined by:

- Hepatic: total bilirubin < 2.0 mg/dl, AST < 3 x the upper limit of normal.

- Renal: Calculated creatinine clearance or nuclear GFR ≥ 70 ml/min/1.73 m^2.

- The patient, or for minors, a parent or legal guardian, must give informed written
consent indicating they are aware of the investigational nature of this study.

EXCLUSION CRITERIA:

- Unable to start study prescribed therapy within 42 days of neurosurgical resection of
the tumor

- Age less than 3 years > 1.5 cm2 residual tumor on post-operative head MRI

- Evidence of leptomeningeal dissemination on head or spine MRI or CSF cytology
positivity

- Evidence of extra-neural metastases

- Prior radiation therapy or chemotherapy for the medulloblastoma

- Inadequate CSF flow on 111-Indium DTPA flow study Patients with signs or symptoms
suggestive of increased intracranial pressure (headache, emesis, ocular paresis) will
not be eligible until they are cleared by neurology and/or neurosurgery.

- Pregnancy

- Total bilirubin ≥ 2.0 mg/dl

- AST ≥ 3 x the upper limit of normal

- Creatinine clearance and GFR < 70 ml/min/1.73 m^2