PT-10 * THE ROLE OF SURGERY IN PEDIATRIC BRAIN TUMORS IN POSTERIOR FOSSA

Abstract

INTRODUCTION: Intracranial tumors are the most common solid tumors in children. The infratentorial compartment will be the primary site for 60 - 70% of these tumors. Recent advances in the categorization of childhood brain tumors have improved risk-based treatment planning. The purpose of this study was to provide a review of the treatment of pediatric brain tumors in posterior fossa with emphasis on the role of surgery in the hierarchy of treatment option. MATERIALS AND METHODS: Twelve children ranging in the age from 7 months to 14 years were enrolled in this study. They were divided into 3 groups according to the following criteria; group I: tumors that currently have promising standard therapy; group II: tumors that currently have no or few promising standard therapy; group III: pathologically benign tumors. RESULTS: Four children with medulloblastoma were categorized into group I and all survived. Group II was constituted by many tumors, including AT/RT, GBM, anaplastic ependymoma, and ependymoma. The prognosis in group II was dismal. Two children with astrocytoma and oligodendroglial gliomatosis were categorized into group III and all survived. CONCLUSIONS: Adjuvant therapies, including radiotherapy and chemotherapy were effective in group I and III, therefore, tumor resection must be performed to avoid neurological sequelae and late effects. In group II, neurosurgery plays an important role for improving survival rate. Since each tumor has a different therapeutic schema and purpose of surgery, therefore, must be different, neurosurgeon should perform surgery with deep consideration in terms of the therapeutic history of each tumor.