A critical appraisal of the role of brachytherapy for pediatric brain tumors.

While brachytherapy is increasingly being utilized in adult patients with brain tumors, there has been very little experience with this approach in pediatric patients. This report reviews the current published experience with brachytherapy for brain tumors in children. Intracavitary irradiation with radioactive colloid is quite effective in controlling cystic craniopharyngiomas and represents an alternative approach to this subgroup of patients with craniopharyngiomas. There has been a substantial experience with the use of permanent interstitial implants in cases of low-grade astrocytoma in Europe, but its value is difficult to judge because of the variable natural history of these slow-growing neoplasms. Very few high-grade astrocytomas have been treated with brachytherapy in children, but children with localized recurrences after conventional therapy should be considered for this approach.