Recent advances in the treatment of childhood brain tumors

Pediatric brain tumors are the commonest cause of cancer-related death in children. The last four decades have seen only a 35% increase in 5-year survival rate of children with these tumors. The therapeutic successes achieved are due to advances in neuroimaging, surgical techniques, radiotherapy, and induction of newer chemotherapeutic agents along with molecular targeted therapy. Neuroimaging advances include the use of MRA, MRS, DSA, and PET scans. With the use of stereotactic surgery, intraoperative mapping, and imaging, surgical resection has improved with significant decrease in morbidity. A major development has been the use of precision guided radiotherapy utilizing technologies like 3D-CRT, SRS, and IMRT, thereby decreasing radiation to normal tissues. Induction of newer drugs and high-dose chemotherapy with peripheral stem cell support has improved survival and delayed radiation in younger children and infants with brain tumors. Intense ongoing research is profiling novel molecular targets for therapeutic intervention. Newer therapeutic strategies like blood brain barrier disruption, immunotherapy, and gene therapy are in clinical trials. This review article intends to give the reader an overview of current therapeutic strategies and research involved in the treatment of children with brain tumors.