**3.3 Adjuvant radiotherapy**

Adjuvant radiotherapy of the primary site is the standard of care in high-risk neuroblastoma patients to reduce the risk of recurrence [6, 37]. Bennett et al. [7] suggested prophylactic irradiation craniospinal axis due to high propensity of CSF metastasis and recurrence of PCNS-NB [6]. However, the role of radiotherapy in PCNS-NB is not well elucidated. This is because the side effects of radiotherapy in the younger age group of radionecrosis and cognitive decline limit its applicability. Lu et al. [16] found a variable practice pattern of adjuvant radiotherapy and reported better survival and no significant side effects of radiotherapy, contrary to other studies.
