Brain Tumors down arrow

Home > Disclaimer > Medulloblastoma > Prognosis





Early Effects

Side effects of radiation therapy (RT) can be thought of in terms of early, early delayed and late effects.


  • During treatment and the first month after RT

Early effects are largely due to inflammation and swelling of normal tissues during the radiation therapy

Therapy Early side effect
Craniospinal RT

Tiredness and general malaise during therapy

  • Generally not too severe


  • Especially at beginning of therapy
  • Due to minor increase in intracranial pressure
  • Responds to steroid medication

Nausea and poor appetite:

  • Related to raised intracranial pressure
  • Related to low dose of RT exiting through the abdomen and affecting intestines
  • Responds well to Zofran (Ondansetron)


  • Mucosa of oropharynx and esophagus is inflamed by RT
  • Starts after about 3 weeks therapy
  • Careful attention should be pain to patient's nutritional status
  • Patient may need analgesics (may have to use codeine as Tylenol may mask a fever)
  • By the end of therapy (depending on dose of RT) patient may need IV or gastric tube feeding

Low blood counts:

  • RT to the entire skull and spine together with chemotherapy can lead to very low blood counts
  • May require transfusion

Skin reaction and hair loss:

  • Hair loss over entire scalp after about 3 weeks of therapy will occur
  • Skin is likely to become red and itchy especially behind the ears and within the posterior fossa boost volume
  • Topical steroids can be helpful during therapy
  • Flamazine is very helpful immediately after the end of therapy

Middle ear inflammation:

  • Unusual
  • Associated with fluid build up



  • Up to 6 months after RT
  • Lhermitte's phenomenon:
    • Electric shock sensation radiating down the spine or into the limbs with flexion of the neck
    • Due to transient demyelination of the thoracic cord
    • Rarely seen after craniospinal RT for medulloblastoma
  • Somnolence syndrome:
    • Lethargy about 6 - 8 weeks after the completion of RT
    • Due to transient demyelination
    • Not associated in the long-term with an increased risk of neurocognitive problems
    • Resolves spontaneously after 2 - 4 weeks
    • Unusual in children treated for brain tumors





Back to top