Multidisciplinary Care of Patients with Brain Tumors

Challenges and opportunities for managing pediatric central nervous system tumors in China

“…23 Timely recognition by caregivers and referral from primary care centers, informative radiographic imaging and staging, maximal yet safe neurosurgical resection, timely neuropathologic interpretation, standardized regimens of adjuvant therapy with necessary supportive care, and coordinated long-term surveillance are indispensable for successfully treating most pediatric CNS tumors. 10,11,24 Despite advances in medical training and the availability of diagnostic and therapeutic resources within the country, Chinese patients and families frequently encounter difficulties receiving coordinated care from specialized centers. A lack of relevant specialists within initial treatment centers (often a neurosurgical unit), suboptimal communication among disciplines within institutions, unavailability of regional referral pathways, undefined standards of care, and demand for second opinions in China and internationally are all contributing factors for these difficulties.…”

“…24,25 These deficiencies necessitate establishing MDTs in the referral centers capable of offering multimodal therapy for children with CNS tumors. 10,23 Primary and secondary care centers should partner with tertiary regional and/or national institutions via a hub-and-spoke model to ensure timely referral and adequate continuity of care. [26][27][28][29] In 1997, Chinese health care providers collaborated to establish the Chinese Children's Cancer Group (CCCG), which is a national consortium pioneered by more than 20 tertiary pediatric oncology centers.…”

“…Multidisciplinary input is key to achieving satisfactory outcomes for children with CNS tumors 23 . Timely recognition by caregivers and referral from primary care centers, informative radiographic imaging and staging, maximal yet safe neurosurgical resection, timely neuropathologic interpretation, standardized regimens of adjuvant therapy with necessary supportive care, and coordinated long‐term surveillance are indispensable for successfully treating most pediatric CNS tumors 10,11,24 . Despite advances in medical training and the availability of diagnostic and therapeutic resources within the country, Chinese patients and families frequently encounter difficulties receiving coordinated care from specialized centers.…”

“…These deficiencies necessitate establishing MDTs in the referral centers capable of offering multimodal therapy for children with CNS tumors 10,23 . Primary and secondary care centers should partner with tertiary regional and/or national institutions via a hub‐and‐spoke model to ensure timely referral and adequate continuity of care 26‐29 .…”

“…Central nervous system (CNS) tumors are the most common pediatric solid tumor and have the highest mortality rate among all childhood cancers 9 . The management of pediatric CNS tumors, such as medulloblastoma (MB), glioma, ependymoma, and germ cell tumors, necessitates timely interdisciplinary input from neurosurgeons, radiation oncologists, pediatric oncologists, radiologists, and pathologists 10,11 . The heterogeneity of CNS tumors and rapid advances in our understanding of disease biology complicate efforts to estimate their incidence and formulate standard‐of‐care guidelines 12 .…”