Central Nervous System Tumors Committee

The membership of the Central Nervous System (CNS) Tumors committee includes the expertise of the following specialties: Pediatric hematology/oncology, neurosurgery,  nursing, patient advocacy, clinical research associates, biostatistics, psychology, pathology, radiation oncology, diagnostic imaging, cytogenetics, endocrinology, and pediatric neurology.

Progress

The survival rates for Central Nervous System (CNS) tumors have not seen a dramatic change across the board in the past twenty years, as some childhood cancers have. As a group, CNS tumors currently have the highest mortality rate of any childhood cancer.

Research has, however, made improvements in the treatment of individual subgroups of brain tumors, including several that previously had very poor prognoses. For example, poor-risk medulloblastoma has gone from the 20% survival range, to more recent results in the 50-60% range, and results in standard risk medulloblastoma and infant tumors have also improved over time

Examples of findings from research include:

• It is possible to safely reduce the amount of radiation for children with standard-risk medulloblastoma, which will result in better quality of life for those patients.

• Determination of prognostic factors

For example, studies have shown that the amount of tumor removal influences the survival rate for children with medulloblastoma, ependymoma, and high- and low-risk gliomas, while for other types of CNS, the amount of tumor removed makes less difference in outcome. This has shown surgeons that extensive resection is an appropriate goal in certain tumor types.   Other prognostic factors have been identified as well.

• Genetic testing on tumors

Researchers have identified biological markers associated with outcome and treatment response for a number of tumor types, particularly  infant brain tumors and medulloblastomas. Detection of such genetic abnormalities offers the potential for being able to better tailor treatment for the individual infant or child.

Current focus

Researchers are working to improve treatment for patients with CNS and to improve the long-term quality of life for survivors. Work is currently focused on:

• Better treatments for resistant tumors
• Treatments for challenging high-risk tumor groups
• Better biological ways of subdividing treatments, to better tailor therapy
• Reducing side effects and late effects

Updated December 2008