The role of chemotherapy in the treatment of pediatric brain tumors

Jae-Wook Lee; Nack-Gyun Chung

doi:10.5124/jkma.2012.55.5.420

J Korean Med Assoc > Volume 55(5); 2012 > Article

Lee and Chung: The role of chemotherapy in the treatment of pediatric brain tumors

Focused Issue of This Month

Pediatric Brain Tumors

Journal of the Korean Medical Association

Journal of the Korean Medical Association 2012; 55(5): 420-429.

Published online: May 16, 2012

DOI: http://dx.doi.org/10.5124/jkma.2012.55.5.420

The role of chemotherapy in the treatment of pediatric brain tumors

Jae-Wook Lee, MD, Nack-Gyun Chung, MD

Department of Pediatrics, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.

Corresponding author: Nack-Gyun Chung, cngped@catholic.ac.kr

Received April 02, 2012 Accepted April 16, 2012

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The past 20 to 30 years have seen significant developments in the diagnosis and treatment of pediatric brain tumors, the most common solid organ tumor in children. Advances have been made in imaging methodologies, such as magnetic resonance imaging, surgical approaches to treatment, classification of brain tumors according to pathological and molecular features, and overall understanding of pertinent prognostic factors. Translation of our knowledge into appropriate therapy for each type of brain tumor has resulted in an overall improved survival. However, subtypes of brain tumor that have actually shown enhanced survival are few, and the overall prognosis for children with brain tumors remains poor compared to that of patients treated for other pediatric malignancies. Recent clinical trials aim to minimize treatment-related toxicity for brain tumors with superior survival, while attempting to improve the cure rate for those tumors with continued poor prognosis through intensified treatment, introduction of novel chemotherapeutic drugs, or targeted treatment based on identified molecular markers. This review outlines the overall role of chemotherapy in the treatment of childhood brain tumors, with an emphasis on recently identified molecular markers and current trends in treatment.

Brain neoplasms; Child; Central nervous system; Drug therapy; Targeted therapy

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Table 1

World Health Organization grades of common pediatric brain tumors

From International Agency for Research on Cancer, et al. WHO classification of tumours of the central nervous system. Lyon: International Agency for Research on Cancer; 2007 [3].