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Whole brain radiation therapy

Follow-up

Organs at risk

Brain 

There is a risk of short-term nerve toxicity causing dizziness, nausea, headache and long-term neuropsychiatric changes. Antiemetic treatment should be considered before starting treatment. Long-term neuropsychiatric changes may depend on multiple factors such as age and if chemotherapy is administered simultaneously (especially high-dose MTX). Those at the highest risk are patients over 60 years who receive whole brain radiation after high-dose MTX.   

Lens of the eye

A dose over 4-6 Gy must often be accepted to obtain adequate coverage to structures near the lamina cribrosa. This may pose a risk for cataract development in some patients.  

Pituitary gland

The dosages used are often lower than the tolerance dose for adults, however, endocrine function should be followed long after treatment in children. 

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