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  • Updated 08.23.2023
  • Released 09.11.2006
  • Expires For CME 08.23.2026

Sequelae of treatment of CNS tumors



Pediatric CNS tumors are the most common solid tumor in childhood and have the highest cancer-related mortality (24). With advancements in treatments and a multimodal approach, survivorship has improved, with over 70% surviving over 5 years. Survivors are now experiencing long-term effects of treatments, particularly neurologic complications. A new focus and endpoint for ongoing treatment trials is to improve outcomes as well as de-escalate therapies to limit long-term effects. This article focuses on the neurologic effects of surgery, chemotherapy, radiation, and immunotherapy in survivors of pediatric brain tumors.

Key points

• Although survival from childhood brain tumors has improved greatly, sequelae of their treatment remain problematic.

• Enhanced targeting of brain tumor treatment based on molecular characteristics of the individual tumor holds the promise of avoiding some sequelae of treatment.

• Sequelae of brain tumor treatment during childhood are related to the predominant locations of these tumors, developmental stage of the child, insufficient targeting of treatments to the neoplastic cells, and the potential of de novo oncogenesis and secondary tumors to result from DNA- and replication-targeted therapies.

Historical note and terminology

The impact of CNS tumors on patients is a product of their mortality rates but also the morbidity of sequelae of the tumors and treatments themselves. Neurocognitive sequelae are perhaps the most problematic of the effects of the treatment of CNS tumors; they can occur in both childhood and adulthood.

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