Radiotherapy for pediatric brain tumors. By Buatti JM, Meeks SL, Marcus RB, Mendenhall NP Seminars in Pediatrics Neurology. Most patients are under the age of ten, but it does occasionally occur in adults. Symptoms usually include headaches, balance difficulties, and sometimes double vision. The symptoms are usually caused by blockage of the fluid pathways in the brain by the tumor.
Treatment includes surgery, radiation therapy, and chemotherapy.
Surgery is used to relieve the obstruction to fluid flow and to remove as much of the tumor as possible, but no patients are cured with surgery alone because all medulloblastomas will spread to other areas in the brain if not treated adequately. To prevent this, radiation therapy is given to all sites of fluid circulation. This is called craniospinal irradiation and involves treating the entire brain as well as the sac that surrounds the spinal cord all the way to its farthest extent in the pelvis. Long-term effects of this treatment may occur, but there is no evidence that patients can be cured without it. Chemotherapy is now used in most patients to allow use of a lower dose of radiation to the brain and spine, and the cure rate appears to be better with chemotherapy.