Abstract
<jats:p>Radiation therapy remains a cornerstone in the clinical care of patients with medulloblastoma. Nevertheless, while treatment with radiation improves disease control, it is also associated with potential late effects impacting neurologic and neurocognitive function, pituitary function as well as hearing. The development of secondary, treatment-related malignancies is an uncommon but possible late outcome. In this chapter, we review the role of radiation therapy in medulloblastoma, as well as changes in management that have resulted both from technological therapeutic advancements and enterprising cooperative group clinical trials for this disease. Moreover, with increasing utilization of molecular diagnostics both for prognosis and stratification of treatment, we also endeavor to explore opportunities to further improve the delivery of radiation therapy to patients with varied risk of disease recurrence.</jats:p>