Contemporary issues in the management of childhood brain tumors

The incidence of childhood brain tumors appears to be on the rise caused in part by improvements in neuroimaging and its increased availability. Current protocols for treatment of childhood brain tumors are utilizing chemotherapy more extensively in addition to and in lieu of radiotherapy to improve survival for tumors such as medulloblastoma and high grade astrocytoma, and to lessen treatment related morbidity in infants with malignant brain tumors and in older children with standard risk medulloblastomas and germ cell tumors. The increasing understanding of the molecular events that lead to oncogenesis will help unravel the causes and improve therapy for a group of illnesses that cause significant neurologic morbidity and mortality.