The effect of radiotherapy on the survival of 143 children with low-grade (grade 1 or 2) astrocytomas was evaluated at the Royal Manchester Children’s Hospital, and Christie Hospital and Holt Radium Institute, Manchester, UK. The 5-year survival was 85%, 10-year 79%. and 15-year 72%. Children over 3 years of age had a better prognosis than younger children. Peripherally located tumors, with their easier access and more complete resection, have a significantly better survival outcome than deep-seated tumors. In 68 children whose tumors were completely resected and who required no radiation, the 15-year survival rate was 90%; if radiotherapy was given for some reason the 15-year survival fell to 75% for this peripheral tumor group. All 9 children with deep-seated tumors died when treated with surgery alone; a 15-year survival rate of 64% was obtained in patients who received radiation after surgery for deep tumors. 
COMMENT. Radiation therapy had no benefit and in some cases, an adverse effect in children with superficial tumors that were amenable to complete or near complete resection. In deep seated tumors incompletely resected, radiation after surgery resulted in a significant improvement in survival rates. While radiotherapy may improve the survival rate in children with deep tumors, it can adversely affect the quality of life by causing long-term cognitive dysfunction.