Summary and Further Reading

Chapter 6 - The Essentials in Radiation Oncology for Brain Tumours


  • RT is used for both curative and palliative treatment of brain tumours
  • Craniospinal RT is an essential component of the curative treatment of medulloblastoma
  • Low-dose RT is a curative treatment for intracranial germinomatous germ cell tumours
  • RT has an established role in the adjuvant treatment of high-grade brain tumours
  • RT is used to improve local control of benign brain tumours and tumours not accessible by surgery
  • RT dose fractionation and extent of irradiation depend on the tumour histology and treatment intent
  • Long-term side effects of RT include cognitive impairment, pituitary dysfunction and an increased risk of CVA and secondary tumours
  • Single-fraction radiosurgery is an effective treatment for small solitary brain metastases
  • Corticosteroids and anticonvulsants should not be used prophylactically
  • Corticosteroids at low doses should be reserved for symptom control

Further Reading

Andrews DW, Scott CB, Sperduto PW, et al. Whole brain radiation therapy with or without stereotactic radiosurgery boost for patients with one to three brain metastases: phase III results of the RTOG 9508 randomised trial. Lancet 2004; 363:1665–1672.

Chan MD. Recent technical advances and indications for radiation therapy in low-grade glioma. Semin Radiat Oncol 2015; 25:189–196.

Durand T, Bernier MO, Léger I, et al. Cognitive outcome after radiotherapy in brain tumor. Curr Opin Oncol 2015; 27:510–515.

Gerber NU, Mynarek M, von Hoff K, et al. Recent developments and current concepts in medulloblastoma. Cancer Treat Rev 2014; 40:356–365.

Kocher M, Soffietti R, Abacioglu U, et al. Adjuvant whole-brain radiotherapy versus observation after radiosurgery or surgical resection of one to three cerebral metastases: results of the EORTC 22952-26001 study. J Clin Oncol 2011; 29:134–141.

Lawrence YR, Li XA, el Naqa I, et al. Radiation dose-volume effects in the brain. Int J Radiat Oncol Biol Phys 2010; 76(3 Suppl):S20–S27.

Niyazi M, Brada M, Chalmers AJ, et al. ESTRO-ACROP guideline “target delineation of glioblastomas”. Radiother Oncol 2016; 118:35–42.

Stupp R, Brada M, van den Bent MJ, et al; ESMO Guidelines Working Group. High-grade glioma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2014; 25(Suppl 3):iii93–iii101.

Van Den Bent MJ, Bromberg JE, Buckner J. Low-grade and anaplastic oligodendroglioma. Handb Clin Neurol 2016; 134:361–380.

Weller M, Wick W, Aldape K, et al. Glioma. Nat Rev Dis Primers 2015; 1:15017.

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Last update: 18 September 2017