Radiotherapy in Neuro-Oncology

Abstract This chapter provides an overview of radiation therapy specific to the central nervous system (CNS). The roles of each member of the planning and treatment teams are described, followed by a brief explanation of the radiobiologic effects of therapeutic radiation. The treatment modalities most commonly used for CNS tumors are described (e.g., photon, proton, and stereotactic radiation), highlighting common delivery systems. The chapter discusses treatment paradigms for specific diagnoses including high-grade gliomas (HGG), low-grade gliomas (LGG), brain metastases, benign brain tumors (meningioma, vestibular schwannoma, craniopharyngioma), and pediatric malignancies (medulloblastoma, ependymoma, diffuse pontine glioma). Radiation toxicity is discussed in the context of each diagnosis and treatment modality, as well as mitigation techniques to minimize the risk of radiation induced side effects.