ABSTRACT
The central nervous system (CNS) is host to a remarkable variety of primary tumours that demonstrate an equal diversity of clinical behaviour, response to treatment and prognosis. The tumour spectrum varies with age. The majority of brain tumours in children arise infratentorially or in the midline. The main aims of surgery in CNS tumours are to establish a tissue diagnosis, palliate symptoms and improve survival. The value of radiation in the treatment of CNS tumours largely depends on their intrinsic radiosensitivity. In rare diagnoses like medulloblastoma or germ cell tumours it may be curative, whereas in most conditions it results only in a modest improvement in survival. Whole-brain or whole-CNS radiotherapy is reserved for patients with evidence of dissemination. Supra-tentorial high-grade tumours should be treated as glioblastomas and carry a similar prognosis. CNS germ cell tumours can be divided into two broad groups: germinomas and non-germinomatous germ cell tumours.
