The authors found preserved cognitive function at 2 years posttreatment but long-term results were not available.In addition, secondary malignancies were not another feared long-term complication of radiation.In addition, clinical trials have documented that radiation therapy to only the cranium results in metastasis to the spine (even in the absence of positive cytology or radiographic evidence of spread).

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Some institutions use different regimens including higher doses in several fractions. Unfortunately, radiation can have a destructive influence on the developing nervous system.

Complications of radiotherapy can include lowered intelligence quotient (IQ) score, small stature, endocrine dysfunction, behavioral abnormalities, and secondary neoplasms (experienced by those fortunate to have prolonged survival).

For the patient with few neurological signs and little hydrocephalus, the entire presurgical workup can be facilitated on an outpatient basis.

Admit patients with significant neurological symptoms (especially those with either change in mental status or imaging evidence of considerable hydrocephalus such as transependymal edema) to the hospital in a monitored setting.

Reduction in IQ and neurobehavioral function is related directly to the age at which radiation is administered.

Radiotherapy, however, remains the most effective adjunct for medulloblastoma and is used in children despite its consequences.

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To reduce radiation dose or postpone irradiation until it can be better tolerated, chemotherapy utilization is focusing on young children.