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Pediatric glial tumors.

K J Cohen¹, A Broniscer, J Glod

¹Pediatric Oncology, Johns Hopkins Oncology Center, CMSC-800, 600 N. Wolfe Street, Baltimore, MD 21287, USA. kcohen@jhmi.edu

Current Treatment Options in Oncology

|June 12, 2002

Summary

Pediatric glial neoplasms differ from adult types, with infratentorial tumors predominating. Maximal surgical resection is key for pilocytic astrocytomas and ependymomas, while radiation and chemotherapy play evolving roles.

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Area of Science:

Pediatric neuro-oncology
Pediatric glial neoplasms
Pediatric brain tumors

Background:

Pediatric glial neoplasms are heterogeneous, differing significantly from adult gliomas in histology and location.
Infratentorial tumors, including posterior fossa and brain stem gliomas, are more common in children than adults.

Purpose of the Study:

To review the characteristics and treatment strategies for three common pediatric glial tumors: diffuse intrinsic pontine gliomas, pilocytic astrocytomas, and ependymomas.
To highlight the differences in therapeutic approaches based on tumor type and patient age.

Main Methods:

Review of current therapeutic strategies including maximal surgical resection, radiation therapy, and chemotherapy.
Discussion of the role and efficacy of each treatment modality for specific pediatric glial tumor types.

Main Results:

Maximal surgical resection is the primary treatment for pilocytic astrocytomas and ependymomas, crucial for favorable outcomes.
Radiation therapy is standard for ependymomas and used for pontine gliomas to slow progression; its role in pilocytic astrocytomas is for specific cases.
Chemotherapy's role is evolving, showing efficacy in young children with pilocytic astrocytomas and ependymomas, but not curative for diffuse intrinsic pontine gliomas.

Conclusions:

Treatment of pediatric glial neoplasms requires tailored approaches based on histology and location.
While surgery and radiation are mainstays for some tumors, chemotherapy offers a vital alternative, especially in young children.
Diffuse intrinsic pontine gliomas remain uniformly lethal despite current therapeutic advancements.

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