Prevention of radiotherapy-induced neurocognitive dysfunction in survivors of paediatric brain tumours: the potential role of modern imaging and radiotherapy techniques.

Prevention of radiotherapy-induced neurocognitive dysfunction in survivors of paediatric brain tumours: the potential role of modern imaging and radiotherapy techniques.
Neurocognitive dysfunction is the leading cause of reduced quality of life in long-term survivors of pediatric brain tumours with radiotherapy being a main contributor to this. This is a review of the potential role of modern imaging and innovative radiotherapy techniques with the goal of minimizing neurocognitive sequelae in children with brain tumours and how to integrate such strategies into further research. Such techniques include evaluation of photon radiotherapy such as image-guided radiotherapy, volumetric nodulated arc therapy, helical tomotherapy and adapative radiotherapy along with proton beam radiation and heavy in therapy.
This article is a descriptive summary of various advanced techniques in radiotherapy to limit long term sequelae as well as proposing strategies to integrate such advances in further research. The only technique thus far that has achieved some success to limit long-term sequelae is avoidance of radiation particularly in those less than 3 years of age, and reduction of the total radiation dose and brain volume irradiated.
Minimizing neurocognitive sequalae in children with brain tumors is challenging. Avoidance of radiation especially in under 3 years and reduction of radiation dose and brain volume irradiated, are the most successful strategies to date.

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