Skip to main content

Advertisement

Log in

Advances in the Management of Paediatric High-Grade Glioma

  • Pediatric Oncology (S Epelman, Section Editor)
  • Published:
Current Oncology Reports Aims and scope Submit manuscript

Abstract

High-grade gliomas represent a formidable challenge to paediatric oncologists. The second most common malignant brain tumour of childhood, little progress has been made in the outcome of these tumours in the last four decades. Outcome remains dire with less than 20 % of patients surviving. Current treatment consists of maximal resection and radiotherapy, with chemotherapy both in conjunction with and adjuvant to radiotherapy being added more recently. Yet much of the evidence for the use of chemotherapy is extrapolated from adult data, and evidence for its use in the paediatric population is weak. Recent advances in the biology of high-grade glioma in children identify epigenomic subgroups distinct from those seen in adults, suggesting a separate tumourigenic mechanism and delineating a separate disease entity. The time may be to move forward with a different way of thinking about paediatric tumours. With biological insight comes the promise of more effective therapies, rationally targeted towards the biology of the tumour. This review addresses the current advances in paediatric high-grade glioma and how we can move forward to translate this into improved outcomes for these patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Louis DN, Ohgaki H, Wiestler OD, Cavenee WK, Burger PC, Jouvet A, et al. The 2007 WHO classification of tumours of the central nervous system. Acta Neuropathol. 2007;114(2):97–109.

    Article  PubMed Central  PubMed  Google Scholar 

  2. Dolecek TA, Propp JM, Stroup NE, Kruchko C. CBTRUS statistical report: primary brain and central nervous system tumors diagnosed in the United States in 2005-2009. Neuro Oncol. 2012;14 Suppl 5:v1–49. doi:10.1093/neuonc/nos218.

    Article  PubMed Central  PubMed  Google Scholar 

  3. Dohrmann GJ, Farwell JR, Flannery JT. Glioblastoma multiforme in children. J Neurosurg. 1976;44(4):442–8. doi:10.3171/jns.1976.44.4.0442.

    Article  CAS  PubMed  Google Scholar 

  4. Bulik M, Jancalek R, Vanicek J, Skoch A, Mechl M. Potential of MR spectroscopy for assessment of glioma grading. Clin Neurol Neurosurg. 2013;115(2):146–53. doi:10.1016/j.clineuro.2012.11.002.

    Article  PubMed  Google Scholar 

  5. Heideman RL, Kuttesch Jr J, Gajjar AJ, Walter AW, Jenkins JJ, Li Y, et al. Supratentorial malignant gliomas in childhood: a single institution perspective. Cancer. 1997;80(3):497–504.

    Article  CAS  PubMed  Google Scholar 

  6. Benesch M, Wagner S, Berthold F, Wolff JE. Primary dissemination of high-grade gliomas in children: experiences from four studies of the Pediatric Oncology and Hematology Society of the German Language Group (GPOH). J Neurooncol. 2005;72(2):179–83. doi:10.1007/s11060-004-3546-5.

    Article  PubMed  Google Scholar 

  7. Wisoff JH, Boyett JM, Berger MS, Brant C, Li H, Yates AJ, et al. Current neurosurgical management and the impact of the extent of resection in the treatment of malignant gliomas of childhood: a report of the Children's Cancer Group trial no. CCG-945. J Neurosurg. 1998;89(1):52–9. doi:10.3171/jns.1998.89.1.0052.

    Article  CAS  PubMed  Google Scholar 

  8. Kramm CM, Wagner S, Van Gool S, Schmid H, Strater R, Gnekow A, et al. Improved survival after gross total resection of malignant gliomas in pediatric patients from the HIT-GBM studies. Anticancer Res. 2006;26(5B):3773–9.

    PubMed  Google Scholar 

  9. Qaddoumi I, Sultan I, Gajjar A. Outcome and prognostic features in pediatric gliomas: a review of 6212 cases from the Surveillance, Epidemiology, and End Results database. Cancer. 2009;115(24):5761–70. doi:10.1002/cncr.24663.

    Article  PubMed Central  PubMed  Google Scholar 

  10. Wolff JE, Gnekow AK, Kortmann RD, Pietsch T, Urban C, Graf N, et al. Preradiation chemotherapy for pediatric patients with high-grade glioma. Cancer. 2002;94(1):264–71.

    Article  CAS  PubMed  Google Scholar 

  11. Finlay JL, Boyett JM, Yates AJ, Wisoff JH, Milstein JM, Geyer JR, et al. Randomized phase III trial in childhood high-grade astrocytoma comparing vincristine, lomustine, and prednisone with the eight-drugs-in-1-day regimen. Childrens Cancer Group. J Clin Oncol. 1995;13(1):112–23.

    CAS  PubMed  Google Scholar 

  12. Sposto R, Ertel IJ, Jenkin RD, Boesel CP, Venes JL, Ortega JA, et al. The effectiveness of chemotherapy for treatment of high grade astrocytoma in children: results of a randomized trial. A report from the Childrens Cancer Study Group. J Neurooncol. 1989;7(2):165–77.

    Article  CAS  PubMed  Google Scholar 

  13. Pollack IF, Finkelstein SD, Woods J, Burnham J, Holmes EJ, Hamilton RL, et al. Expression of p53 and prognosis in children with malignant gliomas. N Engl J Med. 2002;346(6):420–7. doi:10.1056/NEJMoa012224.

    Article  CAS  PubMed  Google Scholar 

  14. Esteller M, Garcia-Foncillas J, Andion E, Goodman SN, Hidalgo OF, Vanaclocha V, et al. Inactivation of the DNA-repair gene MGMT and the clinical response of gliomas to alkylating agents. N Engl J Med. 2000;343(19):1350–4. doi:10.1056/NEJM200011093431901.

    Article  CAS  PubMed  Google Scholar 

  15. Cohen KJ, Pollack IF, Zhou T, Buxton A, Holmes EJ, Burger PC, et al. Temozolomide in the treatment of high-grade gliomas in children: a report from the Children's Oncology Group. Neuro Oncol. 2011;13(3):317–23. doi:10.1093/neuonc/noq191. Results of the Childrens Oncology Group ACNS0126 treating children with radiation and temozolomide showing no benefit over historical controls. Significant as the only comphrensive clinical trial in pediatric high grade glioma.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  16. Pollack IF, Hamilton RL, Sobol RW, Burnham J, Yates AJ, Holmes EJ, et al. O6-methylguanine-DNA methyltransferase expression strongly correlates with outcome in childhood malignant gliomas: results from the CCG-945 Cohort. J Clin Oncol. 2006;24(21):3431–7. doi:10.1200/JCO.2006.05.7265.

    Article  CAS  PubMed  Google Scholar 

  17. Brennan CW, Verhaak RG, McKenna A, Campos B, Noushmehr H, Salama SR, et al. The somatic genomic landscape of glioblastoma. Cell. 2013;155(2):462–77. doi:10.1016/j.cell.2013.09.034.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  18. Kaye AH, Laws ER. Historical perspective. In: Kaye AH, Laws ER, editors. Brain tumors. New York: Churchill Livingston; 1995. p. 3–8.

    Google Scholar 

  19. Wolff JE, Driever PH, Erdlenbruch B, Kortmann RD, Rutkowski S, Pietsch T, et al. Intensive chemotherapy improves survival in pediatric high-grade glioma after gross total resection: results of the HIT-GBM-C protocol. Cancer. 2010;116(3):705–12. doi:10.1002/cncr.24730.

    Article  PubMed  Google Scholar 

  20. Pollack IF, Boyett JM, Yates AJ, Burger PC, Gilles FH, Davis RL, et al. The influence of central review on outcome associations in childhood malignant gliomas: results from the CCG-945 experience. Neuro Oncol. 2003;5(3):197–207. doi:10.1215/S1152-8517-03-00009-7.

    Article  PubMed Central  PubMed  Google Scholar 

  21. Hart MG, Garside R, Rogers G, Stein K, Grant R. Temozolomide for high grade glioma. Cochrane Database Syst Rev. 2013;4, CD007415. doi:10.1002/14651858.CD007415.pub2. Cochrane review showing the benefit of temozolomide in adult high grade glioma.

    PubMed  Google Scholar 

  22. Estlin EJ, Lashford L, Ablett S, Price L, Gowing R, Gholkar A, et al. Phase I study of temozolomide in paediatric patients with advanced cancer. United Kingdom Children's Cancer Study Group. Br J Cancer. 1998;78(5):652–61.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  23. Broniscer A, Chintagumpala M, Fouladi M, Krasin MJ, Kocak M, Bowers DC, et al. Temozolomide after radiotherapy for newly diagnosed high-grade glioma and unfavorable low-grade glioma in children. J Neurooncol. 2006;76(3):313–9. doi:10.1007/s11060-005-7409-5.

    Article  PubMed  Google Scholar 

  24. Nicholson HS, Kretschmar CS, Krailo M, Bernstein M, Kadota R, Fort D, et al. Phase 2 study of temozolomide in children and adolescents with recurrent central nervous system tumors: a report from the Children's Oncology Group. Cancer. 2007;110(7):1542–50.

    Article  CAS  PubMed  Google Scholar 

  25. Bodey B, Siegel SE, Kaiser HE. Up-regulation of VEGF expression and related neo-angiogenesis in childhood high-grade gliomas: implications for anti-angiogenic anti-neoplastic therapy. In Vivo. 2006;20(4):511–8.

    CAS  PubMed  Google Scholar 

  26. Khasraw M, Ameratunga M, Grommes C. Bevacizumab for the treatment of high-grade glioma: an update after phase III trials. Expert Opin Biol Ther. 2014;14(5):729–40. doi:10.1517/14712598.2014.898060.

    Article  CAS  PubMed  Google Scholar 

  27. Narayana A, Kunnakkat S, Chacko-Mathew J, Gardner S, Karajannis M, Raza S, et al. Bevacizumab in recurrent high-grade pediatric gliomas. Neuro Oncol. 2010;12(9):985–90. doi:10.1093/neuonc/noq033.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  28. Couec ML, Andre N, Thebaud E, Minckes O, Rialland X, Corradini N, et al. Bevacizumab and irinotecan in children with recurrent or refractory brain tumors: toxicity and efficacy trends. Pediatr Blood Cancer. 2012;59(1):34–8. doi:10.1002/pbc.24066.

    Article  PubMed  Google Scholar 

  29. Parekh C, Jubran R, Erdreich-Epstein A, Panigrahy A, Bluml S, Finlay J, et al. Treatment of children with recurrent high grade gliomas with a bevacizumab containing regimen. J Neurooncol. 2011;103(3):673–80. doi:10.1007/s11060-010-0444-x.

    Article  CAS  PubMed  Google Scholar 

  30. Gururangan S, Chi SN, Young Poussaint T, Onar-Thomas A, Gilbertson RJ, Vajapeyam S, et al. Lack of efficacy of bevacizumab plus irinotecan in children with recurrent malignant glioma and diffuse brainstem glioma: a Pediatric Brain Tumor Consortium study. J Clin Oncol. 2010;28(18):3069–75. doi:10.1200/JCO.2009.26.8789.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  31. Batra V, Sands SA, Holmes E, Geyer JR, Yates A, Becker L, et al. Long-term survival of children less than six years of age enrolled on the CCG-945 phase III trial for newly-diagnosed high-grade glioma: a report from the Children's Oncology Group. Pediatr Blood Cancer. 2014;61(1):151–7. doi:10.1002/pbc.24718.

    Article  CAS  PubMed  Google Scholar 

  32. Duffner PK, Krischer JP, Burger PC, Cohen ME, Backstrom JW, Horowitz ME, et al. Treatment of infants with malignant gliomas: the Pediatric Oncology Group experience. J Neurooncol. 1996;28(2–3):245–56.

    CAS  PubMed  Google Scholar 

  33. Sanders RP, Kocak M, Burger PC, Merchant TE, Gajjar A, Broniscer A. High-grade astrocytoma in very young children. Pediatr Blood Cancer. 2007;49(7):888–93. doi:10.1002/pbc.21272.

    Article  PubMed  Google Scholar 

  34. Dufour C, Grill J, Lellouch-Tubiana A, Puget S, Chastagner P, Frappaz D, et al. High-grade glioma in children under 5 years of age: a chemotherapy only approach with the BBSFOP protocol. Eur J Cancer. 2006;42(17):2939–45. doi:10.1016/j.ejca.2006.06.021.

    Article  CAS  PubMed  Google Scholar 

  35. Grundy RG, Wilne SH, Robinson KJ, Ironside JW, Cox T, Chong WK, et al. Primary postoperative chemotherapy without radiotherapy for treatment of brain tumours other than ependymoma in children under 3 years: results of the first UKCCSG/SIOP CNS 9204 trial. Eur J Cancer. 2010;46(1):120–33. doi:10.1016/j.ejca.2009.09.013.

    Article  CAS  PubMed  Google Scholar 

  36. Geyer JR, Finlay JL, Boyett JM, Wisoff J, Yates A, Mao L, et al. Survival of infants with malignant astrocytomas. A Report from the Childrens Cancer Group. Cancer. 1995;75(4):1045–50.

    Article  CAS  PubMed  Google Scholar 

  37. Picard D, Miller S, Hawkins CE, Bouffet E, Rogers HA, Chan TS, et al. Markers of survival and metastatic potential in childhood CNS primitive neuro-ectodermal brain tumours: an integrative genomic analysis. Lancet Oncol. 2012;13(8):838–48. First to charachterise molecular subgroups in supratentorial PNET, identifying poor prognostic infants with the C19MC amplicon. These patients can be identified by FISH for C19MC and may be contaminating high grade glioma series.

    Article  PubMed Central  PubMed  Google Scholar 

  38. Kotecha RS, Burley K, Junckerstorff RC, Lee S, Phillips MB, Cole CH, et al. Chemotherapy increases amenability of surgical resection in congenital glioblastoma. Pediatr Hematol Oncol. 2012;29(6):538–44. doi:10.3109/08880018.2012.706867.

    Article  CAS  PubMed  Google Scholar 

  39. Phillips HS, Kharbanda S, Chen R, Forrest WF, Soriano RH, Wu TD, et al. Molecular subclasses of high-grade glioma predict prognosis, delineate a pattern of disease progression, and resemble stages in neurogenesis. Cancer Cell. 2006;9(3):157–73. doi:10.1016/j.ccr.2006.02.019.

    Article  CAS  PubMed  Google Scholar 

  40. Verhaak RG, Hoadley KA, Purdom E, Wang V, Qi Y, Wilkerson MD, et al. Integrated genomic analysis identifies clinically relevant subtypes of glioblastoma characterized by abnormalities in PDGFRA, IDH1, EGFR, and NF1. Cancer Cell. 2010;17(1):98–110. doi:10.1016/j.ccr.2009.12.020.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  41. Noushmehr H, Weisenberger DJ, Diefes K, Phillips HS, Pujara K, Berman BP, et al. Identification of a CpG island methylator phenotype that defines a distinct subgroup of glioma. Cancer Cell. 2010;17(5):510–22. doi:10.1016/j.ccr.2010.03.017.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  42. Sturm D, Witt H, Hovestadt V, Khuong-Quang DA, Jones DT, Konermann C, et al. Hotspot mutations in H3F3A and IDH1 define distinct epigenetic and biological subgroups of glioblastoma. Cancer Cell. 2012;22(4):425–37. doi:10.1016/j.ccr.2012.08.024. Identification of distinct subgroups of paediatric high grade glioma based on global methylation arrays. Charachterisation by key, potentially targetable mutations, clinical features and location. May form the basis of future targeted therapy.

    Article  CAS  PubMed  Google Scholar 

  43. Sturm D, Bender S, Jones DT, Lichter P, Grill J, Becher O, et al. Paediatric and adult glioblastoma: multiform (epi)genomic culprits emerge. Nat Rev Cancer. 2014;14(2):92–107. doi:10.1038/nrc3655. Comprehensive review of current knowledge of the biology of high grade gliomas, both in adults and paediatrics.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  44. Schwartzentruber J, Korshunov A, Liu XY, Jones DT, Pfaff E, Jacob K, et al. Driver mutations in histone H3.3 and chromatin remodelling genes in paediatric glioblastoma. Nature. 2012;482(7384):226–31. doi:10.1038/nature10833. First to identify and define histone mutations in paediatric GBM. May form the basis of future targeted therapies.

    Article  CAS  PubMed  Google Scholar 

  45. Wu G, Broniscer A, McEachron TA, Lu C, Paugh BS, Becksfort J, et al. Somatic histone H3 alterations in pediatric diffuse intrinsic pontine gliomas and non-brainstem glioblastomas. Nat Genet. 2012;44(3):251–3. doi:10.1038/ng.1102. First to identify somatic mutation in histone H3.3. Further charachterisation of histone mutations in DIPG and HGG along with reference 44.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  46. Bax DA, Gaspar N, Little SE, Marshall L, Perryman L, Regairaz M, et al. EGFRvIII deletion mutations in pediatric high-grade glioma and response to targeted therapy in pediatric glioma cell lines. Clin Cancer Res. 2009;15(18):5753–61. doi:10.1158/1078-0432.CCR-08-3210.

    Article  CAS  PubMed  Google Scholar 

  47. Bredel M, Pollack IF, Hamilton RL, James CD. Epidermal growth factor receptor expression and gene amplification in high-grade non-brainstem gliomas of childhood. Clin Cancer Res. 1999;5(7):1786–92.

    CAS  PubMed  Google Scholar 

  48. Qaddoumi I, Kocak M, Pai Panandiker AS, Armstrong GT, Wetmore C, Crawford JR, et al. Phase II Trial of Erlotinib during and after Radiotherapy in Children with Newly Diagnosed High-Grade Gliomas. Front Oncol. 2014;4:67. doi:10.3389/fonc.2014.00067.

    Article  PubMed Central  PubMed  Google Scholar 

  49. Solomon MT, Miranda N, Jorrin E, Chon I, Marinello JJ, Alert J, et al. Nimotuzumab in combination with radiotherapy in high grade glioma patients: a single institution experience. Cancer Biol Ther. 2014;15(5):504–9. doi:10.4161/cbt.28021.

    Article  CAS  PubMed  Google Scholar 

  50. Cabanas R, Saurez G, Rios M, Alert J, Reyes A, Valdes J, et al. Treatment of children with high grade glioma with nimotuzumab: a 5-year institutional experience. mAbs. 2013;5(2):202–7. doi:10.4161/mabs.22970.

    Article  PubMed Central  PubMed  Google Scholar 

  51. Geyer JR, Stewart CF, Kocak M, Broniscer A, Phillips P, Douglas JG, et al. A phase I and biology study of gefitinib and radiation in children with newly diagnosed brain stem gliomas or supratentorial malignant gliomas. Eur J Cancer. 2010;46(18):3287–93. doi:10.1016/j.ejca.2010.07.005.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  52. Paugh BS, Qu C, Jones C, Liu Z, Adamowicz-Brice M, Zhang J, et al. Integrated molecular genetic profiling of pediatric high-grade gliomas reveals key differences with the adult disease. J Clin Oncol. 2010;28(18):3061–8. doi:10.1200/jco.2009.26.7252.

    Article  PubMed Central  PubMed  Google Scholar 

  53. Pollack IF, Jakacki RI, Blaney SM, Hancock ML, Kieran MW, Phillips P, et al. Phase I trial of imatinib in children with newly diagnosed brainstem and recurrent malignant gliomas: a Pediatric Brain Tumor Consortium report. Neuro Oncol. 2007;9(2):145–60. doi:10.1215/15228517-2006-031.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  54. Pollack IF, Hamilton RL, Burger PC, Brat DJ, Rosenblum MK, Murdoch GH, et al. Akt activation is a common event in pediatric malignant gliomas and a potential adverse prognostic marker: a report from the Children's Oncology Group. J Neurooncol. 2010;99(2):155–63. doi:10.1007/s11060-010-0297-3.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  55. Nicolaides TP, Li H, Solomon DA, Hariono S, Hashizume R, Barkovich K, et al. Targeted therapy for BRAFV600E malignant astrocytoma. Clin Cancer Res. 2011;17(24):7595–604. doi:10.1158/1078-0432.CCR-11-1456.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  56. Rohle D, Popovici-Muller J, Palaskas N, Turcan S, Grommes C, Campos C, et al. An inhibitor of mutant IDH1 delays growth and promotes differentiation of glioma cells. Science (New York, NY). 2013;340(6132):626–30. doi:10.1126/science.1236062.

    Article  CAS  PubMed Central  Google Scholar 

  57. Zhu J, Wan H, Xue C, Jiang T, Qian C, Zhang Y. Histone deacetylase 3 implicated in the pathogenesis of children glioma by promoting glioma cell proliferation and migration. Brain Res. 2013;1520:15–22. doi:10.1016/j.brainres.2013.04.061.

    Article  CAS  PubMed  Google Scholar 

  58. Masoudi A, Elopre M, Amini E, Nagel ME, Ater JL, Gopalakrishnan V, et al. Influence of valproic acid on outcome of high-grade gliomas in children. Anticancer Res. 2008;28(4C):2437–42.

    PubMed  Google Scholar 

  59. Hummel TR, Wagner L, Ahern C, Fouladi M, Reid JM, McGovern RM, et al. A pediatric phase 1 trial of vorinostat and temozolomide in relapsed or refractory primary brain or spinal cord tumors: a Children's Oncology Group phase 1 consortium study. Pediatr Blood Cancer. 2013;60(9):1452–7. doi:10.1002/pbc.24541.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  60. Ardon H, De Vleeschouwer S, Van Calenbergh F, Claes L, Kramm CM, Rutkowski S, et al. Adjuvant dendritic cell-based tumour vaccination for children with malignant brain tumours. Pediatr Blood Cancer. 2010;54(4):519–25. doi:10.1002/pbc.22319.

    PubMed  Google Scholar 

  61. MacDonald TJ, Aguilera D, Kramm CM. Treatment of high-grade glioma in children and adolescents. Neuro Oncol. 2011;13(10):1049–58. doi:10.1093/neuonc/nor092.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  62. Jones C, Perryman L, Hargrave D. Paediatric and adult malignant glioma: close relatives or distant cousins? Nat Rev Clin Oncol. 2012;9(7):400–13. doi:10.1038/nrclinonc.2012.87.

    Article  CAS  PubMed  Google Scholar 

  63. Ledford H. 'Master protocol' aims to revamp cancer trials. Nature. 2013;498(7453):146–7. doi:10.1038/498146a. Innovative trial design which paediatric trials may follow in the future.

    Article  CAS  PubMed  Google Scholar 

  64. Iwanami A, Gini B, Zanca C, Matsutani T, Assuncao A, Nael A, et al. PML mediates glioblastoma resistance to mammalian target of rapamycin (mTOR)-targeted therapies. Proc Natl Acad Sci U S A. 2013;110(11):4339–44. doi:10.1073/pnas.1217602110.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  65. Stommel JM, Kimmelman AC, Ying H, Nabioullin R, Ponugoti AH, Wiedemeyer R, et al. Coactivation of receptor tyrosine kinases affects the response of tumor cells to targeted therapies. Science (New York, NY). 2007;318(5848):287–90. doi:10.1126/science.1142946.

    Article  CAS  Google Scholar 

Download references

Compliance with Ethics Guidelines

Conflict of Interest

Dr. Jenny Adamski, Dr. Uri Tabori and Dr. Eric Bouffet declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Eric Bouffet.

Additional information

This article is part of the Topical Collection on Pediatric Oncology

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Adamski, J., Tabori, U. & Bouffet, E. Advances in the Management of Paediatric High-Grade Glioma. Curr Oncol Rep 16, 414 (2014). https://doi.org/10.1007/s11912-014-0414-0

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s11912-014-0414-0

Keywords

Navigation