Toxicity of radiotherapy in the treatment for medulloblastoma

Radiation therapy is an integral component of the multimodality treatment of patients with medulloblastoma. Although the pathophysiology of radiation damage to the central nervous system is not entirely known, efforts continue to limit radiation exposure to normal tissue to decrease the associated acute, early delayed, and late delayed toxicities. Current studies continue to address these toxicities in hopes of an uncomplicated cure that achieves the best quality of life possible for survivors of medulloblastoma. This chapter reviews the biologic effect of radiation on cells in the central nervous system, the associated toxicities of treatment, and current approaches to reduce unwanted effects of radiation to target and non-target tissues.