Journal of Neuro-Oncology

, Volume 75, Issue 3, pp 239–242 | Cite as

Progress and Challenges in Childhood Brain Tumors

Childhood Brain Tumors

Summary

Although many challenges lie ahead, there has been definite progress made in the management of childhood brain tumors. Some of these advances have increased progression-free and overall survival. Other advances, while not improving survival, have resulted in a better quality of life for long-term survivors. Probably the best example of progress is manifest in the outcome of children with medulloblastoma. Seventy percent, and in some subsets as high as 80% of children with this disease can be expected to be cured, compared to approximately 50% three decades ago. This improvement in disease control has been associated with a reduction in the dose of radiotherapy for many patients and possibly an improved quality of survival. For other tumor types, especially brain stem gliomas, there has been little progress made. A primary challenge in the years ahead will be how to integrate biologic discoveries into the care of children for brain tumors, with the hope that molecular biologically based therapy will be more effective and improve the quality of life for survivors.

Keywords

brain stem gliomas chemotherapy childhood brain tumors medulloblastoma radiation therapy stem gliomas 

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References

  1. 1.
    Statistical Report: Primary Brain Tumors in the United States, 1995–1999. Published by the Central Brain Tumor Registry of the United States. CBTRUS, 2002Google Scholar
  2. 2.
    Evans, AE, Jenkin, RD, Sposto, R 1990The treatment of medulloblastoma: results of a prospective randomized trial of radiation therapy with and without CCNU, vincristine, and prednisoneJ Neurosurg72572582PubMedGoogle Scholar
  3. 3.
    Tait, DM, Thorton-Jones, M, Bloom, MJA 1990Adjuvant chemotherapy for medulloblastoma: the first multicenter controlled trial of the International Society of Pediatric Oncology (SIOPI)Eur J Cancer26464469PubMedGoogle Scholar
  4. 4.
    Packer, RJ, Sutton, LN, Elterman, R 1994Outcome for children with medulloblastoma treated with radiation and cisplatin, CCNU, and vincristine chemotherapyJ Neurosurg81690698PubMedGoogle Scholar
  5. 5.
    Packer, RJ, Goldwein, J, Nicholson, HS 1999Treatment of children with medulloblastomas with reduced-dose craniospinal radiation therapy and adjuvant chemotherapy: a Children’s Cancer Group studyJ Clin Oncol1721272136PubMedGoogle Scholar
  6. 6.
    Zeltzer, PM, Boyett, JM, Finlay, JL 1999Metastasis stage, adjuvant treatment and residual treatment are prognostic factors for medulloblastoma in children: conclusions from the Children’s Cancer Group 921 randomized phase III studyJ Clin Oncol17832845PubMedGoogle Scholar
  7. 7.
    Pollack, IF, Polinko, P, Albright, AL 1995Mutism and pseudobulbar symptoms after resection of posterior fossa tumors in children: incidence and pathophysiologyNeurosurgery37885893PubMedGoogle Scholar
  8. 8.
    Pomeroy, SL, Tamayo, P, Gaasenbeck, M 2002Prediction of central nervous system embryonal tumour outcome based on gene expressionNature415436442CrossRefPubMedGoogle Scholar
  9. 9.
    Rorke, LB, Packer, RJ, Biegel, JA 1996Central nervous system atypical teratoid/rhabdoid tumors of infancy and childhood: definition of an entityJ Neurosurg855665PubMedGoogle Scholar
  10. 10.
    Duffner, PK, Horowitz, MD, Krischer, JP 1993Postoperative chemotherapy and delayed radiation in children less than three years of age with malignant brain tumorsN Engl J Med32817251731CrossRefPubMedGoogle Scholar
  11. 11.
    Horn, B, Heideman, R, Geyer, R 1999A multi-institutional retrospective study of intracranial ependymoma in children: identification of risk factorsJ Pediatr Hematol Oncol21203211CrossRefPubMedGoogle Scholar
  12. 12.
    Robertson, PL, Zeltzer, PM, Boyett, JM 1998Survival and prognostic factors following radiation and chemotherapy for ependymomas in children: a report of the Children’s Cancer GroupJ Neurosurg88685694Google Scholar
  13. 13.
    Merchant, TE, Mulhern, RK, Krasin, MJ 2004Preliminary results from a phase II trial of conformal radiation therapy and evaluation of radiation-related CNS effects for pediatric patients with localized ependymomaJ Clin Oncol2231563162CrossRefPubMedGoogle Scholar
  14. 14.
    Grill, J, LeDelay, MC, Gambarell, E 2001Post-operative chemotherapy without irradiation for ependymoma in children under 5 years of age: a multi-centered trial of the French Society of Pediatric OncologyJ Clin Oncol1912881296PubMedGoogle Scholar
  15. 15.
    Packer, RJ, Ater, J, Allen, J 1997Carboplatin and vincristine chemotherapy for children with newly diagnosed progressive low-grade gliomasJ Neurosurg86747754PubMedGoogle Scholar
  16. 16.
    Packer, RJ, Allen, JC, Goldwein, JL 1990Hyperfractionated radiotherapy for children with brainstem gliomas: a pilot study using 7,200 cGyAnn Neurol27167173CrossRefPubMedGoogle Scholar
  17. 17.
    Packer RJ, Vezina LG: Management of brain stem gliomas. In: Tindall GT (ed) Gliomas. Neurosurgical Consultations, Vol. 4: pp. 1–7, 1993Google Scholar
  18. 18.
    Finlay, J, Boyett, J, Yates, A 1995Randomized phase II trial in childhood high-grade astrocytoma comparing vincristine, lomustine and prednisone with eight-drug-in-1-day regimenJ Clin Oncol3112123Google Scholar

Copyright information

© Springer 2005

Authors and Affiliations

  1. 1.Center for Neuroscience and Behavioral MedicineUSA
  2. 2.Department of NeurologyChildren’s National Medical Center WashingtonUSA
  3. 3.Department of NeurologyThe George Washington University,USA
  4. 4.University of VirginiaCharlottesvilleUSA

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