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Pediatric Radiotherapy: Background and Current Paradigms

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Textbook of Pediatric Neurosurgery

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Abstract

Traditional photon-based radiation therapy (RT) is an integral component to the treatment of pediatric central nervous system tumors. In combination with advances in surgical management, chemotherapeutic regimens, and small molecule inhibitors, RT has helped improve survival and cure rates substantially. However, successful treatment and long-term survival have revealed many late-appearing adverse effects from irradiating normal tissue. With increased recognition of these sequelae, treatment approaches have become more sophisticated, integrating new technologies and strategies aimed at reducing dose to nontarget areas. The use of proton-based RT has been gaining traction recently as one such approach, along with image guidance radiation therapy (IGRT). In the era of personalized medicine, the molecular revolution in pediatric oncology has better stratified disease subgroups, allowing for appropriate radiotherapeutic escalation or de-escalation depending on biological insights, more accurate prognosis, and the success of other interventions. In this chapter, we review basic concepts in radiation oncology, recent advances in the field, and the current treatment paradigms for the most common pediatric CNS tumors. In particular, the authors discuss medulloblastoma, ependymoma, intracranial germ cell tumors, suptratentorial premative neuroectodermal tumors (sPNET), intradural spinal cord tumors, and low-grade gliomas.

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Author information

Authors and Affiliations

  1. University of Tennessee Health Science Center, Memphis, TN, USA

    Ryan P. Lee

  2. Department of Radiation Oncology, St. Jude Children’s Research Hospital, Memphis, TN, USA

    Christopher L. Tinkle, John T. Lucas Jr & Thomas E. Merchant

  3. Department of Neurosurgery, Le Bonheur Children’s Hospital, University of Tennessee Health Science Center, Memphis, TN, USA

    Frederick A. Boop

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  1. Ryan P. Lee
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  2. Christopher L. Tinkle
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  3. John T. Lucas Jr
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  4. Thomas E. Merchant
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  5. Frederick A. Boop
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Corresponding author

Correspondence to Thomas E. Merchant .

Editor information

Editors and Affiliations

  1. Pediatric Neurosurgery, International Neuroscience Institute, Hannover, Germany

    Concezio Di Rocco

  2. Department of Paediatric Neurosurgery, Great Ormond Street Hospital for Children, NHS Trust, London, UK

    Dachling Pang

  3. Division of Neurosurgery, The Hospital for Sick Children, Toronto, ON, Canada

    James T. Rutka

Section Editor information

  1. Director of Pediatric Neurosurgery, International Neuroscience Institute, Hannover, Germany

    Concezio Di Rocco

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Lee, R.P., Tinkle, C.L., Lucas, J.T., Merchant, T.E., Boop, F.A. (2020). Pediatric Radiotherapy: Background and Current Paradigms. In: Di Rocco, C., Pang, D., Rutka, J. (eds) Textbook of Pediatric Neurosurgery. Springer, Cham. https://doi.org/10.1007/978-3-319-72168-2_7

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