HE INTRODUCTION OF MORE EFfective treatments for childhood cancer has dramatically improved survival rates, implying that childhood cancer survivors comprise a rapidly growing group of young adults. 1,2 Unfortunately, improved prognosis has been accompanied by the occurrence of late, treatment-related complications such as second neoplasms, organ dysfunction, and psychosocial and cognitive problems. 3,4 Late treatment sequelae will increase the incidence of chronic diseases in survivors and ultimately re-For editorial comment see p 2762.

CCSs have a high risk of developing symptomatic CEs at an early age. The most common CE was CHF. Survivors treated with both anthracyclines and radiotherapy have the highest risk; after 30 years, one in eight will develop severe heart disease. The use of potentially cardiotoxic treatments should be reconsidered for high-risk groups, and frequent follow-up for high-risk survivors is needed.

In this large randomized European study, which enrolled patients with standard-risk medulloblastoma from more than 100 centers, excellent survival rates were achieved in patients without a large postoperative residual tumor and without RT treatment delays. EFS and OS for HFRT was not superior to STRT, which therefore remains standard of care in this disease.