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<jats:title>Summary</jats:title><jats:p>Survival rates for average-risk medulloblastoma exceed 80%; however, long-term sequelae are substantial. A study from Mumbai, India evaluated the role of omission of craniospinal irradiation. Albeit unsuccessful, this study raises the crucial question of how low therapy can be safely de-escalated with the intent of improving quality of survival.</jats:p><jats:p>See related article by Gupta et al., p. 4180</jats:p>