Radiation for CNS tumors

Radiation therapy plays a critical role in the curative treatment of many children with central nervous system tumors. In certain tumors including medulloblastoma and germ cell tumors, the role of irradiation is especially important. This presentation will review prognostic features that have been found to be of importance in the cure of medulloblastoma and will briefly review technical aspects of radiation treatment found to be of importance in conventional treatment of children with this condition. Integration of modern chemotherapy with irradiation will also be discussed and the impact this integration has achieved will be presented. Using these integrated modalities in standard fashion has resulted in overall long-term disease-free survival of approximately 40% ten years following initial therapy. Current attempts at addition of novel radiation approaches to improve overall results, especially in high-risk patients will be presented. Finally, attempts to substitute cytotoxic chemotherapy for conventional radiation approaches for primary CNS Germinoma will be discussed and recent results presented. For comparison, results utilizing initial irradiation will be presented, as will attempts at salvage irradiation in patients relapsing after initial chemotherapy