Brain Tumours

How can we reduce the risks associated with CSI?

Second cancers  Patients with MB at highest risk of a 2 nd malignancy of all CNS tumours  Actuarial risk at 20-30 years 4-10%  Especially  2 nd CNS tumour (glioma, meningioma)  Soft tissue sarcoma incl desmoid  Thyroid  Skin cancers

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Risk reduction 

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Reduce dose outside the target  New techniques