Radiotherapy Options of Brainstem Tumors

Abstract

The brainstem is the connecting structure that joins the long tract from the cerebral hemispheres and midline diencephalic nuclei with the cerebellar tracts, forming the spinal cord as the tracts exit through the foramen magnum. Within the brainstem are the nuclei of the cranial nerves, the reticular activating system, and vital function centers (e.g., respiratory). The brainstem includes three anatomic segments: the midbrain, the pons, and the medulla. Brainstem gliomas account for 20 % of all central nervous system tumors in children. They can be focal, dorsal exophytic tumors or diffuse infiltrating types. The management depends on the location and imaging characteristics. Treatment of diffuse tumors include radiotherapy with or without chemotherapy. Even with the high technological advances in the planning and delivery of radiation the outcomes of this tumors are still poor.