Overview of CNS Gliomas in Childhood

Lee, Mee Jeong

Abstract

Brain tumor is the second most common tumor in childhood. The overall survival (OS) has improved significantly during the past 30 years due to developments in surgical technique, radiotherapy, chemotherapy, and high-dose chemotherapy and autologous peripheral stem cell rescue. At present, the 5 year OS of pediatric brain tumor is about 75% which, however, is still lower than that of other malignancies in childhood. Various clinical studies using radiotherapy combined with chemotherapy, multidrug chemotherapy, and monoclonal antibody have been conducted in order to cure patients with brain tumor. The Korean Society of Pediatric Neuro-Oncology is trying to develop standard therapy for the various types of pediatric brain tumor. Of special note, the standard treatment for pediatric glioma has not yet been established. Glioma is the most common histologic type of brain tumor in children. They are classified into 3 groups based on the WHO grade and location of tumor; low-grade glioma (LGG), high-grade glioma (HGG), and brainstem glioma (BSG). The prognosis of LGG is usually good if a complete surgical resection is feasible. Incomplete resected or progressive LGG are troublesome disease for pediatric oncologists. The survival rate of HGG and BSG is very low in spite of combined treatments with surgery, radiation, and chemotherapy. The aim of this review is to provide an overview of treatments for pediatric gliomas.