title: An analysis of the late effects of radiotherapy in pediatric central nervous system tumors.
abstract: OBJECTIVE
  The purpose of this study is to assess the long term results of all pediatric patients diagnosed with central nervous system (CNS) tumors treated with external beam radiotherapy either primarily or postoperatively.
  
  
  METHODS
  Forty-seven pediatric patients with CNS tumors were treated between 1978 and 1989 with external beam radiotherapy to customized fields using cobalt 60, 4, 6, or 18 MV photons. Daily doses ranged from 1.5 to 2.0 Gray; total doses from 35 to 66 Gray. Ages ranged from one month to 18 years of age, with an average age of 8.2 years. Thirty-nine patients survived more than 12 months (range 36 to 178 months; median 62 months) and were included for analysis. Ten of 39 (25.6%) patients experienced Grade I to II complications and six patients had (15.7%) Grade III to IV complications for an overall incidence of 41%. The influence of field size, radiation dose, chemotherapy, age, and extent of surgical resection upon long-term complications were studied.
  
  
  CONCLUSIONS
  Radiation therapy for pediatric CNS malignancies is associated with long-term complications. Significant long-term complications can be limited to an acceptable level of approximately 15%.
authors.affiliation: St. Luke's Hospital, Radiation Oncology Center, Chesterfield, Missouri, USA.
authors.forename: D F
authors.initials: DF
authors.lastname: Butler
authors.forename: B O
authors.initials: BO
authors.lastname: Jose
authors.forename: K J
authors.initials: KJ
authors.lastname: Paris
authors.forename: W J
authors.initials: WJ
authors.lastname: Spanos
authors.forename: R D
authors.initials: RD
authors.lastname: Lindberg
authors.forename: L J
authors.initials: LJ
authors.lastname: Goldsmith
mesh_terms: D000293:Adolescent; D001932:Brain Neoplasms / Q000401:mortality / Q000532:radiotherapy*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011879:Radiotherapy Dosage; D011882:Radiotherapy, High-Energy / Q000009:adverse effects*; D016019:Survival Analysis; D013997:Time Factors