Pediatric brain tumors

Abstract

Radiation therapy is an important treatment option for the management of pediatric brain tumors. Conventional radiation therapy carries significant risk for late-effect toxicity when used in young children and infants, and is associated with neurocognitive impairments, endocrinopathies, developmental deficits, and secondary malignancies. Due to its conformal nature, stereotactic radiosurgery can deliver highly focused doses of radiation while sparing surrounding brain parenchyma, helping to offset many of the adverse effects of conventional irradiation of the brain and spine. Gamma Knife and CyberKnife are the common stereotactic radiosurgical modalities used in this population. Because of its frameless nature, CyberKnife is a unique device that may obviate the need for general anesthesia and allow treatment in very young children and infants with thin skulls incompatible with the placement of a ridged stereotactic head-frame. Single session radiosurgery can be offered with the CyberKnife due to the precision of the system for management of pediatric tumors in eloquent locations. Fractionation is also possible and allows for safe delivery of higher dosages of irradiation to the target with a lower risk of complications.