Abstract
Brainstem tumors are of several distinct types that can be broadly classified as either focal or diffusely infiltrating. Most focal tumors are low grade gliomas for which the treatment of choice is surgery. If not feasible, or if and when progression occurs after surgery, chemotherapy, and radiotherapy may be considered, typically chemotherapy for children less than 10 years of age or children of any age with NF-1 and radiotherapy for all others. Although patients may need more than one, and frequently several, interventions (including repeat surgery) over time, the prognosis is very good with an overall survival of approximately 95% at 10 years. This is not the case for diffusely infiltrating pontine tumors for which surgery is not an option and chemotherapy has not proved useful and so these tumors are typically treated with radiotherapy alone. While radiotherapy is a useful treatment for DIPG, in most patients leading to early complete neurological recovery, time to progression is only 5–6 months and median survival is less than 1 year. For both focal and diffusely infiltrating brainstem tumors, new insights into the tumor biology hold promise for new therapeutic targets, potentially reducing risk associated with treatment (surgery, radiotherapy, and/or chemotherapy) for the former and improving tumor control and survival for the latter.
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Freeman, C.R., Farmer, JP., Jabado, N. (2018). Brainstem Tumors. In: Mahajan, A., Paulino, A. (eds) Radiation Oncology for Pediatric CNS Tumors. Springer, Cham. https://doi.org/10.1007/978-3-319-55430-3_13
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DOI: https://doi.org/10.1007/978-3-319-55430-3_13
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