Brain Tumors of Infancy - An Institutional Experience and Review of the Literature

Abstract

Introduction: Brain tumors in infants are rare and form a distinct subgroup of pediatric brain tumors. These tumors differ from tumors in older children with respect to histology and management and tend to have a poorer outcome. Methods: We analyzed 31 consecutive cases of brain tumors in infancy managed in our institute in the last 15 years and reviewed the published literature since 1990. Results: Only 2 of these patients had congenital tumors. Choroid plexus tumors were the most common histological subtype, followed by medulloblastoma; 62% of patients underwent a gross total or near-total excision of the tumor with 1 perioperative mortality; 68% of patients had a good outcome. Conclusion: Choroid plexus tumors were the most common histological type. Safe resection should be the goal of surgery. Surgeries for tumors in this age group were associated with lower rates of total excision and higher morbidity. Low-grade lesions as expected are associated with longer survival; however, long-term outcomes are far from satisfactory.

EGF as a New Therapeutic Target for Medulloblastoma Metastasis

“…Medulloblastoma (MB) is a family of highly-invasive tumors most commonly diagnosed in the pediatric central nervous system (7, 28, 38, 41, 50) . While clinical treatments have more than doubled the overall 5-year survival rate to upwards of 60% (16, 28, 44, 52) , additional therapies are needed to target the aggressive MB migration that is uncharacteristic of other brain tumors, but is a hallmark of MB recurrence, metastasis, and radioresistivity (13, 21, 24, 28, 41, 55, 61, 70) .…”

“…While clinical treatments have more than doubled the overall 5-year survival rate to upwards of 60% (16, 28, 44, 52) , additional therapies are needed to target the aggressive MB migration that is uncharacteristic of other brain tumors, but is a hallmark of MB recurrence, metastasis, and radioresistivity (13, 21, 24, 28, 41, 55, 61, 70) . The migration of cancer cells within the CNS is decidedly complex, affected by cellular interactions with heterogeneous extracellular matrix (ECM) as well as mixed cellular responses to concentration fields of biomolecules (1, 14, 19, 60, 65) .…”

The magnitude and predictors of therapy abandonment in pediatric central nervous system tumors in low‐ and middle‐income countries: Systematic review and meta‐analysis

“…No studies attempted to formally analyze predictors of treatment abandonment in CNS tumors. However, authors of 12 studies reported possible causes of abandonment (Table ), based on their personal experience with patients, patient records, and knowledge of patients’ backgrounds . Only one (Chinese) study conducted a questionnaire with caregivers to identify reasons for abandonment .…”

Feasibility of high‐dose chemotherapy protocols to treat infants with malignant central nervous system tumors: Experience from a middle‐income country

“…Most reports on pediatric CNS tumors from low middle income countries (LMIC) describe the epidemiology of these tumors and rarely describe in detail treatment modalities and outcomes . Due to the limitation of health care resources, protocols in LMIC should not only consider survival, but also quality of survival, feasibility, and costs of therapy.…”