Cancer treatment of the central nervous system has contributed positively to long-term disease-free survival from childhood cancers such as acute leukemia and medulloblastoma. However, intrathecal chemotherapy and whole brain radiation are associated with acute, subacute, and delayed toxicities. The purpose of this review article is to summarize what is known about critical events in prenatal and postnatal brain development; the pathophysiology of radiation and chemotherapy neurotoxicity and clinical manifestations and risk factors for acute, subacute, and delayed toxicities. The importance of long-term follow-up and for multidisciplinary interventions that focus on prevention as well as management of identified problems are addressed.
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