Central nervous system

Abstract

Acute lymphoblastic leukemia and central nervous system (CNS) tumors are the two most common pediatric malignancies, accounting for two-thirds of all pediatric cancers (SEER data 2002–2006). Overall survival rate has improved significantly in the last four decades with the advancement of multidisciplinary treatment. Currently, 1 in 570 young adults between the ages of 20 and 34 years is a childhood cancer survivor, and many of these survivors experience chronic severe medical conditions from previous CNS-directed therapy. Survivors are at risk for late mortality, second neoplasms, neurological and neurosensory deficits, growth failure, endocrinopathies, impaired neurocognitive function, psychological stress and poor social outcomes. In this chapter, the risk factors, clinical presentations, surveillance and intervention of delayed CNS toxicities will be reviewed and discussed.