75 - Primary Nervous System Tumors in Infants and Children

Abstract

Brain tumors are the most common solid tumor of children, and the leading cause of cancer-related death. The etiology, presentation, and treatment of primary brain tumors in children are highly disparate from adult brain tumors, warranting a very different approach. Pediatric brain tumors are frequently in the posterior fossa, and embryonal tumors are the predominant malignant tumor encountered. The genomic landscape of pediatric brain tumors is very different from adults, where recurrent mutations are infrequent, whereas copy number changes and rearrangements predominate. Treatment is highly dependent on the etiology, where embryonal tumors are treated with surgery, craniospinal irradiation, and intensive chemotherapy while gliomas are treated with surgery or chemotherapy/radiation if unresectable. Treatment of pediatric brain tumors carries high morbidity due to the vulnerability of the developing brain, resulting in approaches that try to maximize both overall and functional survival. Genomics has significantly changed our understanding of pediatric brain tumors, and molecular classifications are emerging that allow more precise diagnosis and treatment.