Central nervous system injury by therapeutic irradiation.

Therapeutic irradiation is the cornerstone of therapy for many neoplastic diseases but, at the same time, is capable of causing devastating injury to the brain and spinal cord. Thoughtful planning and meticulous execution of radiotherapy reduces the risk of neurotoxicity, but there remains a small and unavoidable risk of serious injury if an effective radiation dose is to be given. It is hoped that better understanding of the mechanisms of radiation injury will lead to safer yet equally effective therapies.