his is a single-center, prospective observational study in children and adolescents with central nervous system tumors who need whole-brain and whole-spine radiation therapy (craniospinal irradiation, CSI). The study uses proton therapy with a special vertebral body-sparing (VBS) technique to protect the front and center of the vertebrae, which helps preserve bone marrow function and growth. The main goals are to find safe dose limits for the vertebrae and check how often severe side effects occur. The study will also look at bone marrow preservation, spinal deformity, tumor control, survival, chemotherapy completion, neurocognitive function, quality of life, and growth and development for up to 5 years after treatment.
The patient's legal guardian voluntarily signs the written informed consent form.
Age at diagnosis > 3 years and ≤ 18 years.
Histopathologically confirmed diagnosis of a central nervous system (CNS) tumor.
Indication for craniospinal irradiation (CSI) confirmed by multidisciplinary team (MDT) discussion.
Previous receipt of any form of spinal radiotherapy.
Previous major spinal surgery for any reason.
Presence of clinically significant and confirmed spinal deformity at enrollment (e.g., Cobb angle > 10° measured by MRI or X-ray).
Presence of medical contraindications to proton radiotherapy.