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Conformal Radiation Therapy for Childhood CNS Tumors

Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA

Correspondence: Nancy J. Tarbell, M.D., Department of Radiation Oncology, Massachusetts General Hospital, 55 Fruit Street, Bulfinch 360, Boston, Massachusetts 02114, USA. Telephone: 617-724-1836; Fax: 617-724-4808; e-mail: ntarbell{at}partners.org

Radiation therapy plays a central role in the management of many childhood brain tumors. By combining advances in brain tumor imaging with technology to plan and deliver radiation therapy, pediatric brain tumors can be treated with conformal radiation therapy. Through conformal radiation therapy, the radiation dose is targeted to the tumor, which can minimize the dose to normal brain structures. Therefore, by limiting the radiation dose to normal brain tissues, conformal radiation therapy offers the possibility of limiting the long-term side effects of brain irradiation.

In this review, we describe different approaches to conformal radiation therapy for pediatric central nervous system tumors including: A) three-dimensional conformal radiation therapy; B) stereotactic radiation therapy with arc photons; C) intensity-modulated radiation therapy; and D) proton beam radiation therapy. We discuss the merits and limitations of these techniques and describe clinical scenarios in which conformal radiation therapy offers advantages over conventional radiation therapy for treating pediatric brain tumors.

Key Words. Pediatrics • Radiation therapy • Central nervous system neoplasms • Protons • IMRT • Side effects

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