Cranial radiation therapy (CRT) for treatment of brain tumours in paediatric patients can cause subsequent neurocognitive impairment, particularly in patients who were very young at the time of irradiationCRT can impair development of white and grey matter, and can inhibit neurogenesis and synaptic plasticity—two processes that are crucial for learning and academic achievementAdditional factors, such as the tumour itself, hydrocephalus, chemotherapy and other drugs, can contribute to cognitive impairment in survivors of paediatric brain tumoursNew strategies to prevent and treat CRT-induced neurocognitive damage, most notably new radiation techniques that spare healthy brain tissue, are increasingly used to avoid this adverse effect of radiotherapyRehabilitation of paediatric patients treated with CRT is also possible through the child's school environment and cognitive training programmes
CNS malignancies, which represent 30% of childhood tumours, is a term that encompasses a heterogeneous range of diseases. Their treatment is complex and usually combines surgery, chemotherapy and/or targeted therapies, and cranial radiation therapy (CRT).1 Over the past decade, dramatic improvements have been made in the management of paediatric brain tumours, resulting in improved patient survival.1 Medulloblastoma and low-grade glioma are the two most common childhood brain tumours, with a progression-free survival rate of 60–85%.
