— Tumors of the Central Nervous System

Abstract

CNS tumors are usually treated with maximum feasible surgical resection, often followed by chemotherapy and radiation therapy . CNS tumors are the most common type of childhood tumor treated with radiation therapy, as the use of radiation is confined to a small proportion of children with leukemia . Radiation to the young, developing brain is well documented to be associated with significant toxicities, so its use on brain tumors is limited in children under 3 to 6 years of age to progressive tumors that are resistant to chemotherapy . In an age-dependent manner, these toxicities include lowered intelligence quotient (IQ) scores, impaired memory, impaired growth and abnormal hormone production, changes in behavior, hearing loss, and vision impairment . Studies have shown that the consequences of cognitive impairment during childhood are significantly lower educational attainment, less household income, less full time employment, and fewer marriages (Ellenberg et al . 2009) . These effects are a result of radiation damage to specific structures that can be protected if identified during the planning process . In addition to these risks that can manifest in months to a few years, there is the chance of producing second malignancies much later in life (also see Chapter 2) .