Update on new treatments and developments in childhood brain tumors.
OBJECTIVE
Childhood primary central nervous system tumors remain a therapeutic conundrum. As the second most common pediatric cancer, brain tumors lead to significantly worse survival and long-term effects compared with those seen with hematologic malignancies and other solid tumors. This review discusses current management strategies in three pediatric brain tumors, the long-term effects of therapy, as well as novel laboratory findings that may alter future treatment strategies.


RESULTS
The current literature focuses on tactics to predict those at risk of treatment failure and long-term effects. By analyzing tumors at a molecular genetics level rather than traditional histology, new data have begun to emerge on methods to begin to consider targeted therapies, tailored to the individual child. Furthermore, as survivorship has improved with current radiation and chemotherapy regimens, long-term effects have been identified and merit clinical attention.


CONCLUSIONS
Even though long-term survival for children with a brain tumor approaches 70%, the need for improved treatment regimens is striking. Secondary malignancies, neurocognitive deficits and treatment failure continue to afflict these children and young adults. The current review will inform clinicians of the challenges faced by basic scientists and clinicians when treating brain tumors, and point to future research directions.
Partap
Sonia
S
Department of Neurology, Stanford University, Stanford, California 94305-5826, USA. spartap@stanford.edu
Fisher
Paul Graham
PG
D000818:Animals; D001932:Brain Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D002648:Child; D004806:Ependymoma / Q000628:therapy; D005910:Glioma / Q000175:diagnosis / Q000532:radiotherapy; D006801:Humans; D016609:Neoplasms, Second Primary; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000453:epidemiology; D011878:Radiotherapy / Q000009:adverse effects; D011879:Radiotherapy Dosage; D017741:Survivors