Long-Term Follow-Up of Pediatric CNS Tumor Survivors—A Selection of Relevant Long-Term Issues

Abstract

Introduction: Survivors of pediatric central nervous system (CNS) tumors are at high risk for late effects and long-term morbidity. The quality of survival became increasingly important, as advances in diagnostics, multimodal treatment strategies, and supportive care have led to significant increases in long-term survival. Aim: This review aims to provide a global overview of the potential late effects and long-term follow-up care of CNS tumor survivors, directed to trainees and practitioners with less targeted training in pediatric oncology. Late effects in CNS tumor survivors: A specific focus on CNS tumor survivors relies on cognitive and psychosocial late effects, as they may have an impact on education, professional career, independent living, and quality of life. Further important late effects in CNS tumor survivors include endocrine, metabolic, cardiovascular, and cerebrovascular diseases. Conclusions: Comprehensive long-term follow-up care is essential for pediatric CNS tumor survivors to improve their quality of survival and quality of life. An individualized approach, taking all potential late effects into account, and carried out by an interdisciplinary team, is recommended, and should continue into adulthood. Existing recommendations and guidelines on long-term follow-up care guide the multidisciplinary teams.

Life after paediatric brain tumour; the perspectives of the survivors and their parents

“…This supports the significance of long‐term follow‐up care as recommended in national and international guidelines (e.g. PanCare, the International Guideline Harmonization Group (IGHG), The Children's Oncology Group (COG), the Dutch Childhood Oncology Group (DCOG), therapy‐based long‐term follow‐up guideline in UK, and the Scottish Intercollegiate Guidelines Network (SIGN)) (as reviewed in Otth et al, 2022; Scottish Intercollegiate Guidelines Network (SIGN), 2013). This influences how and when healthcare personnel (HCPs) should provide information and support regarding the potential long‐term and late effects (Hovén et al, 2018).…”

“…radiation, chemotherapy and/or surgery) seem to be particularly decisive (Doger de Spéville et al, 2021). It is important to acknowledge the major advancements in the detection and treatment of PBT in recent decades (Stensvold et al, 2017) that have successfully minimized some late effects (Otth et al, 2022). This can explain the large variations in the functioning of the heterogeneous sample of PBT survivors in the current study, involving survivors that recently completed treatment and long‐term survivors.…”

“…Such coping strategies are associated with improved health outcomes, reduced psychological distress and post-traumatic growth (Shin et al, 2020). (Stensvold et al, 2017) that have successfully minimized some late effects (Otth et al, 2022).…”

Rare Coexistence: Pilocytic Astrocytoma With Atypical Teratoid/Rhabdoid Tumor Features in an Infant

“…Resource limitations pose significant barriers to optimal diagnosis and management of pediatric brain tumors, particularly in low- and middle-income countries [ 13 ]. Access to specialized diagnostic techniques, such as molecular profiling and advanced imaging modalities, may be limited in such settings, leading to diagnostic uncertainties and delays in treatment initiation.…”

Nanoparticles for Drug and Gene Delivery in Pediatric Brain Tumors’ Cancer Stem Cells: Current Knowledge and Future Perspectives

“…Advances in surgery, radiotherapy and chemotherapy have ameliorated the survival rate for some cancers, such as medulloblastoma (MB) and pediatric low-grade glioma (pLGG), but for diffuse intrinsic pontine glioma (DIPG) and high-grade gliomas (pHGG) the prognosis is still poor [ 2 ]. However, current therapies applied to pediatric tumors worsen patient’s quality of life and are associated with long-term sequelae in terms of endocrine, neurological and cognitive disorders [ 3 , 4 ]. Advances in molecular and gene profiling of brain tumors have improved diagnosis, risk stratification and identification of aberrant genetic pathways, allowing us to appreciate differences with adult tumors and paving the way for new “personalized” treatment modalities.…”