Neurological Complications of Pediatric Cancer

Neil, Elizabeth; Hanmantgad, Sharyu; Khakoo, Yasmin

doi:10.1177/0883073815620673

Cited by 16 publications

(7 citation statements)

References 44 publications

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“…Generally, management of these chemotherapy associated complications is supportive care. Intolerable neurologic side effects can often be managed by dose reduction or modifying the treatment regimen ( 18 ). Table 1 summarizes neurologic side effects of commonly used chemotherapeutic agents for the treatment of brain tumors.…”

Section: Traditional Therapiesmentioning

confidence: 99%

Review: Neurological Complications From Therapies for Pediatric Brain Tumors

2022

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Surgery, chemotherapy and radiation have been the mainstay of pediatric brain tumor treatment over the past decades. Recently, new treatment modalities have emerged for the management of pediatric brain tumors. These therapies range from novel radiotherapy techniques and targeted immunotherapies to checkpoint inhibitors and T cell transfer therapies. These treatments are currently investigated with the goal of improving survival and decreasing morbidity. However, compared to traditional therapies, these novel modalities are not as well elucidated and similarly has the potential to cause significant short and long-term sequelae, impacting quality of life. Treatment complications are commonly mediated through direct drug toxicity or vascular, infectious, or autoimmune mechanisms, ranging from immune effector cell associated neurotoxicity syndrome with CART-cells to neuropathy with checkpoint inhibitors. Addressing treatment-induced complications is the focus of new trials, specifically improving neurocognitive outcomes. The aim of this review is to explore the pathophysiology underlying treatment related neurologic side effects, highlight associated complications, and describe the future direction of brain tumor protocols. Increasing awareness of these neurologic complications from novel therapies underscores the need for quality-of-life metrics and considerations in clinical trials to decrease associated treatment-induced morbidity.

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Section: Traditional Therapiesmentioning

confidence: 99%

Review: Neurological Complications From Therapies for Pediatric Brain Tumors

2022

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“…These approaches were possible due to increased hematopoietic recovery in children as compared to adults, improvements in supportive care including blood product transfusions, infection control measures, better baseline organ function in children, and a tolerance of heightened toxicity as a cost of improved survival [33] . This has resulted in long-term morbidity for survivors, including effects on growth, neurocognitive development, endocrine health, predisposition to metabolic syndrome, cardiotoxicity, pulmonary toxicity, nephrotoxicity, fertility issues, and secondary malignancy risk; these have been reviewed more comprehensively elsewhere [34][35][36][37][38][39][40] . These outcomes emphasize how the identification of treatment resistance mechanisms and resultant counterstrategies are needed to reduce treatment intensity and toxicity while improving survival, which we now discuss [ Figure 1].…”

Section: Specific Considerations Of Pediatric Cancers and Pediatric Cmentioning

confidence: 99%

Dodging the bullet: therapeutic resistance mechanisms in pediatric cancers

Shah¹

2019

CDR

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While advances in the treatment of pediatric cancers have improved survival to > 80% across all tumor types, drug resistance continues to limit survival for a considerable number of patients. We review the known mechanisms of resistance in pediatric cancers, including processes that impair conventional chemotherapies, newer classes of targeted small molecule antineoplastic drugs, and monoclonal antibodies. We highlight similarities and differences in treatment approach and resistance between pediatric and adult cancers. We also discuss newer areas of research into drug resistance, including extracellular and immune factors.

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“…Neurologic complications are particularly common and can be associated with severe morbidity and long-term sequelae. [4][5][6][7] Radiologists are critical players in multidisciplinary teams caring for children with cancer and are often called upon to help diagnose therapeutic complications and differentiate them from other conditions such as tumor recurrence, infection, and secondary malignancy. This review article is the first part in a 2-part review that aims to illustrate the typical imaging findings of cancer therapyrelated toxicities, divided into early and late treatment effects.…”

mentioning

confidence: 99%

“…Complications may occur acutely after initiation of treatment or months to years later and can affect any organ system. Neurologic complications are particularly common and can be associated with severe morbidity and long-term sequelae 4–7 …”

mentioning

confidence: 99%

Complications of Cancer Therapy in Children: A Comprehensive Review of Neuroimaging Findings

Snyder

Sarma

Poussaint

et al. 2023

J Comput Assist Tomogr

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Complications of cancer therapy in children can result in a spectrum of neurologic toxicities that may occur at the initiation of therapy or months to years after treatment. Although childhood cancer remains rare, increasing survival rates mean that more children will be living longer after cancer treatment. Therefore, complications of cancer therapy will most likely occur with increasing frequency.At times, it is very difficult to differentiate between therapeutic complications and other entities such as tumor recurrence, development of secondary malignancy, and infection (among other conditions). Radiologists often play a key role in the diagnosis and evaluation of pediatric patients with malignancies, and thus, awareness of imaging findings of cancer complications and alternative diagnoses is essential in guiding management and avoiding misdiagnosis. The aim of this review article is to illustrate the typical neuroimaging findings of cancer therapy–related toxicities, including both early and late treatment effects, highlighting pearls that may aid in making the appropriate diagnosis.

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Neurological Complications of Pediatric Cancer

Cited by 16 publications

References 44 publications

Review: Neurological Complications From Therapies for Pediatric Brain Tumors

Review: Neurological Complications From Therapies for Pediatric Brain Tumors

Dodging the bullet: therapeutic resistance mechanisms in pediatric cancers

Complications of Cancer Therapy in Children: A Comprehensive Review of Neuroimaging Findings

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