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Treatment of posterior fossa tumors in children
Dattatraya Muzumdar1, Enrique C G Ventureyra
1Division of Neurosurgery, Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, Ontario K1H 8L1, Canada.
Insights
Pediatric posterior fossa tumors require prompt diagnosis and neurosurgical intervention. Advances in chemoradiation and molecular genetics offer improved treatment and potential cures for these challenging brain tumors.
Area of Science:
- Pediatric neuro-oncology
- Neurosurgery
- Radiation oncology
- Molecular genetics
Background:
- Posterior fossa tumors are common in children, with medulloblastoma, astrocytoma, and ependymoma being most frequent.
- Rarer tumors include atypical teratoid rhabdoid tumors and brain stem gliomas.
- The confined space of the posterior fossa leads to early symptom presentation, necessitating urgent treatment to prevent severe outcomes.
Purpose of the Study:
- To highlight the critical importance of early detection and diagnosis of pediatric infratentorial brain tumors.
- To emphasize the role of prompt neurosurgical consultation in optimal management.
- To discuss current treatment strategies and emerging advances in pediatric posterior fossa tumors.
Main Methods:
- Surgical resection is the primary treatment modality, providing biopsy and tumor decompression.
- Adjuvant therapies, including chemoradiation, are frequently required.
- Recent advancements focus on improved radiation delivery techniques and pharmacological agents.
Main Results:
- Prompt surgical intervention is crucial for managing pediatric posterior fossa tumors.
- Adjuvant therapies enhance treatment efficacy.
- Ongoing research in radiation biology and molecular genetics is vital for improving outcomes.
Conclusions:
- Early diagnosis and neurosurgical management are paramount for pediatric posterior fossa tumors.
- Multimodal treatment approaches, incorporating surgery, chemoradiation, and targeted therapies, are essential.
- Translational research and molecular genetics hold significant promise for achieving cures for these malignant pediatric brain tumors.
Abstract:
The most common posterior fossa tumors in children are medulloblastoma, astrocytoma and ependymoma. Atypical rhabdoid teratoid tumors and brain stem gliomas are relatively rare. As the posterior fossa is a limited space, the tumors presenting in this region cause symptoms early on and require prompt treatment to avoid potential morbidity and mortality. Early detection and diagnosis of these tumors and prompt neurosurgical consultation is crucial in the optimum management of pediatric infratentorial brain tumors. Surgery is the mainstay of treatment, as it provides biopsy and decompression of the tumor. Adjuvant therapy is required in the majority of cases. Recent advances in the field of radiation biology and pharmacology have improved dose and delivery techniques of chemoradiation therapy. In the current era, advances in translational research and molecular genetics have assumed a major role in the pursuit of achieving a 'cure' for these potentially malignant tumors.
