Characterization, Treatment, and Outcome of Intracranial Neoplasms in the First 120 Days of Life

Qaddoumi, Ibrahim; Carey, Steven S.; Conklin, Heather M.; Jenkins, Jesse J.; Sabin, Noah D.; Boop, Frederick A.; Pai-Panandiker, Atmaram; Baker, Justin N.; Wright, Karen; Broniscer, Alberto; Gajjar, Amar

doi:10.1177/0883073811401398

Cited by 18 publications

(5 citation statements)

References 34 publications

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“…Despite a trend in literature towards worse outcome in children diagnosed in the first year of life, we could not confirm this finding in our cohort, noting however a trend towards worse OS in children diagnosed in the first 6 months of life (Fig. S1) [28]. This may be explained by differences in patient characteristics (age at diagnosis limited to 5 years or younger in this study) and tumor distribution (e.g.…”

Section: Discussioncontrasting

confidence: 79%

Central nervous system tumors in children under 5 years of age: a report on treatment burden, survival and long-term outcomes

et al. 2022

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Purpose The challenges of treating central nervous system (CNS) tumors in young children are many. These include age-specific tumor characteristics, limited treatment options, and susceptibility of the developing CNS to cytotoxic therapy. The aim of this study was to analyze the long-term survival, health-related, and educational/occupational outcomes of this vulnerable patient population. Methods Retrospective study of 128 children diagnosed with a CNS tumor under 5 years of age at a single center in Switzerland between 1990 and 2019. Results Median age at diagnosis was 1.81 years [IQR, 0.98–3.17]. Median follow-up time of surviving patients was 8.39 years [range, 0.74–23.65]. The main tumor subtypes were pediatric low-grade glioma (36%), pediatric high-grade glioma (11%), ependymoma (16%), medulloblastoma (11%), other embryonal tumors (7%), germ cell tumors (3%), choroid plexus tumors (6%), and others (9%). The 5-year overall survival (OS) was 78.8% (95% CI, 71.8–86.4%) for the whole cohort. Eighty-seven percent of survivors > 5 years had any tumor- or treatment-related sequelae with 61% neurological complications, 30% endocrine sequelae, 17% hearing impairment, and 56% visual impairment at last follow-up. Most patients (72%) attended regular school or worked in a skilled job at last follow-up. Conclusion Young children diagnosed with a CNS tumor experience a range of complications after treatment, many of which are long-lasting and potentially debilitating. Our findings highlight the vulnerabilities of this population, the need for long-term support and strategies for rehabilitation, specifically tailored for young children.

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Section: Discussioncontrasting

confidence: 79%

Central nervous system tumors in children under 5 years of age: a report on treatment burden, survival and long-term outcomes

et al. 2022

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“…Objective assessment at four years shows average cognition similar to those in the HeadStart initiative (154). However, survivors of neonatal tumors continue to fare poorly, with over half having IQ under 70 (155). 2).…”

Section: Prevention Of Cancer-related Cognitive Dysfunction By Cancer Treatment Modificationmentioning

confidence: 72%

Developing Interventions for Cancer-Related Cognitive Dysfunction in Childhood Cancer Survivors

Castellino

Ullrich

Whelen

et al. 2014

JNCI Journal of the National Cancer Institute

135

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Survivors of childhood cancer frequently experience cancer-related cognitive dysfunction, commonly months to years after treatment for pediatric brain tumors, acute lymphoblastic leukemia (ALL), or tumors involving the head and neck. Risk factors for cancer-related cognitive dysfunction include young age at diagnosis, treatment with cranial irradiation, use of parenteral or intrathecal methotrexate, female sex, and pre-existing comorbidities. Limiting use and reducing doses and volume of cranial irradiation while intensifying chemotherapy have improved survival and reduced the severity of cognitive dysfunction, especially in leukemia. Nonetheless, problems in core functional domains of attention, processing speed, working memory and visual-motor integration continue to compromise quality of life and performance. We review the epidemiology, pathophysiology and assessment of cancer-related cognitive dysfunction, the impact of treatment changes for prevention, and the broad strategies for educational and pharmacological interventions to remediate established cognitive dysfunction following childhood cancer. The increased years of life saved after childhood cancer warrants continued study toward the prevention and remediation of cancer-related cognitive dysfunction, using uniform assessments anchored in functional outcomes.

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“…While in a recent review, teratoma was found to be the most common congenital tumor followed by gliomas and choroid plexus papillomas, while embryonal tumors including medulloblastomas and atypical teratoid/rhabdoid tumors (ATRTs) are less frequent [33]. Ependymoma is another subtype that is diagnosed also in infants [34] although its incidence is higher under the age of four years [33]. Pinealoblastomas and craniopharyngiomas are other tumors that are encountered more rarely in this age group [25,35].…”

Section: Histopathology and Locationmentioning

confidence: 99%

Brain tumors in the first two years of life

Enayet

2021

Egypt J Neurosurg

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Background Brain tumors in the first years of life are frequently encountered recently with the advancement in neuroimaging, neurosurgery and neuroanethesia where early diagnosis of these lesions became available even before birth. Their management is challenging where the surgery is technically demanding, radiotherapy is omitted in this age because of its late sequelae and chemotherapy role may be beneficial, but it is limited also by its side effects and neurotoxicity. The aim of this article is to review the current literature about the brain tumors in the first two years of life, their diagnosis and treatment. Main body Brain tumors in the first two years of life encompass mainly fetal/congenital tumors and infantile tumors. They account for 1.4–18% of cases of pediatric brain tumor, and most of them are diagnosed in the first year of life. The main histopathologies diagnosed are glial tumors, choroid plexus tumors, medulloblastoma and other embryonal tumors, teratoma and ependymoma. They are mainly supratentorial. Large head and bulging fontanelles are the main presenting symptoms and signs secondary to increased intracranial pressure secondary to large tumors or associated hydrocephalus. Prenatal and postnatal ultrasonography represents the initial imaging step in the diagnosis that should be complemented by MRI and CT brain. The main and first line of treatment of infantile brain tumors is surgical excision as the prognosis is directly related to the extent of resection besides surgery offers specimens for histopathological diagnosis and adjuvant chemotherapy is given for residual irresectable cases and malignant tumors with the main aim to delay radiotherapy beyond the age of three years. Conclusion Brain tumors in the first two years of life are a challenging group of different histopathological entities with underlying specific molecular characterization and genetic predispositions. They have aggressive behavior and general poor prognosis with limited options of management. Individualized multidisciplinary management for each case is needed, and future studies for therapeutic medications targeting underlying molecular biology may improve their outcome.

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Characterization, Treatment, and Outcome of Intracranial Neoplasms in the First 120 Days of Life

Cited by 18 publications

References 34 publications

Central nervous system tumors in children under 5 years of age: a report on treatment burden, survival and long-term outcomes

Central nervous system tumors in children under 5 years of age: a report on treatment burden, survival and long-term outcomes

Developing Interventions for Cancer-Related Cognitive Dysfunction in Childhood Cancer Survivors

Brain tumors in the first two years of life

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