As survival rates for central nervous system cancers continue to improve, clinicians increasingly face the challenge of managing long-term treatment effects. This presentation will share findings from a systematic review of symptoms of late radiation brain injury and radiation-induced brain necrosis across behavioural, cognitive, physical/motor, and functional domains. By demonstrating that the clinical burden extends beyond what is detectable on neuroimaging alone, this presentation will examine the need for standardised, longitudinal symptom monitoring, informed by patient-level factors, to support early detection, diagnostic clarity, multidisciplinary treatment planning, and survivorship care.