Recurrent Central Nervous System Tumors

Abstract

As with most other childhood malignancies, the reappearance of an intracranial tumor either locally or at distant sites after primary therapy implies a dire prognosis. However, retreatment may provide long subsequent survival or even cure of patients with recurrent biologically non-aggressive tumors such as pituitary adenoma, craniopharyngioma, meningioma, and cerebellar astrocytoma. Even the patient with a recurrent biologically aggressive tumor such as medulloblastoma may derive significant palliation and even cure from retreatment. Retreatment is more likely to be beneficial if administered when the recurrent tumor is still localized to a small volume and before apparent dissemination via the cerebral spinal fluid (CSF) pathways has occurred. Also, retreatment will be better tolerated if administered before deterioration in neurological status.