Radioterapija možganskih tumorjev otrok = Radiotherapy for pediatric brain tumors
Petrič-Grabnar, Gabrijela
Today, over a half of children with brain tumors are expected to survive to adulthood. In radiotherapy for brain tumors, the irradiated volume always includes a proportion of healthy tissue, thus ...entailing a risk of not only acute but also late sequelae of treatment *e. g. disorders in soft tissue and hone growth, neurocognitive development dis- orders, endocrine gland dysfunction*, as well as the appearence of secondary tumors. The risk of RT-related late seyuelae is higher in children up to 3 years of age, because of incomplete myelinization process. Therefore, in the selection of treatment method, the possibility of cure should always be weighed against the possible treatment-related toxicity. Children with low-grade gliomas are treated with irra- diation in the case of extensive postoperative resid- ua1 disease, or when surgery is not feasihle due to unfavorable tumor site (brain stem, hypothalamus, optic pathway tumors). RT is further indicated in children with evidence of tumor recurrence on a fol- low-up, although they may be Eree of any clinical symptoms. The irradiated volume comprises the tumor as imaged on CT scan or MRI with a 2 cm safe- ty margin of healthy tissue; the therapeutic dose in children over 3 years of age is 54 Gy given in daily fractions of 1.5 to 1.8 Gy. Children under 3 years of age are treated by chemotherapy *ChT* while RT is postponed. The same treatment approach is also used in children with gliomas of high-grade malignancy and those with low-grade supratentorial ependymomas. Abstract truncated at 2000 characters.
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