High-Dose Chemotherapy/Stem Cell Transplantation (HDSCT)

Most children diagnosed with malignant central nervous system (CNS) tumors are treated with a combined therapy of maximal surgical resection, focal or cranio-spinal irradiation (CSI), and chemotherapy. Unfortunately, the use of radiation treatment is associated with significant long-term deficits especially in young children. The use of high-dose chemotherapy has emerged as an alternative option to preserve outcome with the possibility to omit or delay radiation. For tumors that show a favorable response to chemotherapy, it was speculated that using high-dose chemotherapy to obtain high-dose intensity may further improve outcomes. This chapter discusses the use of high-dose chemotherapy and stem cell rescue for specific CNS tumors and aims to guide the reader as to where this approach may be beneficial.