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Treatment options for paediatric brainstem gliomas

Daniyal Aziz Khan1, Altaf Ali Laghari1, Muhammad Ehsan Bari1

  • 1Aga Khan University Hospital, Karachi, Pakistan.

JPMA. the Journal of the Pakistan Medical Association
|September 13, 2019
PubMed

Insights

Pediatric brainstem gliomas (BSGs) are categorized into focal (FBSGs) and diffuse intrinsic pontine gliomas (DIPG). This review appraises current treatments for aggressive DIPGs, which have a poor prognosis in children.

Area of Science:

  • Pediatric neuro-oncology
  • Neurosurgery
  • Radiation oncology

Background:

  • Paediatric brainstem gliomas (BSGs) are broadly classified into focal (FBSGs) and diffuse intrinsic pontine gliomas (DIPG).
  • FBSGs represent 20% of BSGs, are typically indolent, and have a good prognosis.
  • DIPGs constitute 80% of BSGs, are highly aggressive, malignant brain tumors with a dismal prognosis, and are the leading cause of cancer-related death in children.

Purpose of the Study:

  • To review and appraise current treatment modalities for pediatric brainstem gliomas (BSGs).
  • To highlight the challenges in managing diffuse intrinsic pontine gliomas (DIPGs) due to their location and aggressive nature.

Main Methods:

  • Literature review of current treatment strategies for pediatric brainstem gliomas.
  • Cataloguing and appraisal of therapies including steroids, chemotherapy, radiotherapy, and surgery.

Main Results:

  • Diffuse intrinsic pontine gliomas (DIPGs) are highly aggressive with a poor prognosis.
  • Treatment of DIPGs is complicated by their location in eloquent brainstem areas.
  • A standardized therapeutic framework for DIPGs remains challenging to establish.

Conclusions:

  • Current treatment modalities for pediatric brainstem gliomas (BSGs) require further evaluation.
  • Improved therapeutic strategies are needed for diffuse intrinsic pontine gliomas (DIPGs) to improve patient outcomes.

Keywords:
Diffuse intrinsic pontine glioma (DIPG), Paediatric brains temgliom as, Radio therapy.

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