The treatment of high grade gliomas and diffuse intrinsic pontine tumors of childhood and adolescence: a historical - and futuristic - perspective.

摘要: Pediatric high grade gliomas represent a heterogeneous group of tumors with poor prognoses despite the use multimodal treatment. Very little progress has been made over past decades in identifying efficacious therapeutic modalities against both and diffuse brainstem children. The degree surgical resection is most important clinical prognostic factor for children gliomas, complete should be attempted whenever feasible. role radiation therapy treatment older brain stem undisputed; however benefit using patients less than 6 years age (with gliomas) might questionable. Despite absence solid evidence to support its use, chemotherapy routinely used these tumors. Currently temozolomide being investigated due activity adult trials based on preliminary data regarding recurrent disease. A small subgroup can successfully treated dose followed by autologous cell rescue. Early this modality had associated morbidity mortality. High rescue selected minimal residual disease, angiogenesis inhibitors, radiosensitizers other biological modifiers are currently phase I/II trials.