Year: 2020
Type: article
Abstract: P ediatric patients with primary brain tumors present some of the most challenging cases encountered by neurosurgeons.Brain tumors are the second most common neoplasms in children and the most common solid neoplasms.Furthermore, brain tumors have overtaken leukemia as the leading cause of childhood cancer death. 1 Surgical and adjuvant therapies result in reasonably good survival rates in many pediatric brain tumor types.For instance, standard treatment (maximal safe resection, craniospinal irradiation, and myeloablative chemotherapy) results in long-term survival of greater than 90% in low-risk patients with the Wnt molecular subtype of medulloblastoma.3 However, the intensive therapies necessary to achieve these outcomes often result in permanent cognitive, neurological, and end-organ damage, as well as secondary malignancies later in life.Pediatric high-grade gliomas such as noninfantile glioblastoma, high-grade midline gliomas, and diffuse intrinsic pontine gliomas (DIPGs) have dismal outcomes similar to those seen in their adult counterparts.Even low-grade/benign tumors in children present with significant difficulties given their greater propensity to arise from eloquent structures such as the optic apparatus, hypothalamus, and brainstem, necessitating surgeries associated with increased morbidity and a lifetime of dealing with the direct and indirect effects of the tumor.This issue of Neurosurgical Focus presents key pediatric brain tumor topics of interest with the goal of providing our readers insights into the latest advancements in the field.Arguably, the most difficult to treat of all pediatric brain tumors are DIPGs.These inoperable tumors are resistant to irradiation and chemotherapy, and most affected patients die within a year of diagnosis.Until recently, pathologic confirmation was not necessary to initiate treatment for DIPG; however, in this new age of precision medicine where next-generation sequencing can be leveraged to choose therapies specific for each tumor, biopsy
Source: Neurosurgical FOCUS
Language: English
Subfield: Genetics (clinical)
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W2998655640