- Function of age: The age below which the risks associated with radiotherapy become unacceptable is unknown. Most oncologists use 3 years of age as the lower limit, but others have suggested that craniospinal irradiation should not be considered in children below 5 years of age (15).
- Site and dose dependent: The drawbacks to radiotherapy in children are the well-known, long-term sequelae. Depending on the portion of the CNS that is irradiated, the specific dosing regimen, and, particularly, the age at initiation of radiotherapy, the child who receives craniospinal irradiation is potentially at risk of radiation necrosis, neuroendocrinopathies, and cognitive impairments.
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