Radiation therapy and chemotherapy are used extensively to treat pediatric brain tumors. A few caveats are important. The developing nervous system is exquisitely sensitive to the effects of ionizing radiation. Craniospinal in radiation in children younger than 3 years of age has devastating neuropsychological sequelae. Even in older children, radiation can lead to decline in intellect and decreased school performance. Another added risk is the development of secondary malignancies, especially for those children cured of the primary tumor. Some of the consequences of radiation are being addressed by the use of conformal techniques, radiosurgery and implanted radiation seeds. The long-term effects of these local techniques in children is unknown.
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