Growth abnormalities of the spine after radiation therapy: Respecting the past while moving forward in proton craniospinal irradiation

Modern techniques of craniospinal radiation therapy (CSI) offer the advantage of modulating dose distribution to normal tissues in children and young adults. Reducing risks for second neoplasms and late effects to uninvolved tissues must be a priority for radiation oncologists. This manuscript reviews potential advantages and concerns moving forward with proton beam CSI.