Paediatric brain tumours are the most common type of solid tumours affecting children, ranking second after blood-related cancers among kids aged 0 to 14 years old. These tumours differ significantly from adult brain tumours in terms of their location, symptoms, growth patterns, and microscopic appearance.
For effective treatment, doctors must accurately identify the type and location of the tumour in the child’s brain, guiding the selection of the best treatment options.
Advancements in Classification
In the past, tumours were classified based on their origin and appearance. However, advancements in science and medicine have led to better classification methods, incorporating the tumour’s physical characteristics and genetic features.
Common Types of Paediatric Brain Tumours
Diffuse Intrinsic Pontine Glioma (DIPG)
DIPG is a prevalent brain stem tumour that primarily affects children.
Originating in the pons, a critical region responsible for vital functions like breathing and balance, DIPGs are high-grade tumours known for their aggressive growth and infiltration into surrounding brain tissue.
Unfortunately, due to their location and behaviour, DIPGs have a very poor prognosis, making them one of the most challenging childhood cancers to treat.
Pilocytic Astrocytomas
Pilocytic astrocytomas are low-grade brain tumours that can occur in various brain regions, including the brain stem.
These tumours have a slow growth rate, setting them apart from more aggressive types. As a result, patients diagnosed with pilocytic astrocytomas generally have a more favourable prognosis than those with higher-grade tumours.
Gangliogliomas
Gangliogliomas are unique tumours composed of a combination of glial cells and neurons. While they can occur in the brain stem, they are more commonly found in other areas of the brain. Classified as low-grade tumours, gangliogliomas exhibit slower growth and less aggressive behaviour, leading to a more optimistic prognosis and better treatment outcomes.
Treatments for Managing Paediatric Brain Tumours
Surgery: Surgery is often the first-line treatment for brain tumours, and it can be curative if the tumour is completely removed.
Chemotherapy: Chemotherapy is often used in combination with surgery and/or radiation therapy to treat paediatric brain tumours. However, the efficacy of chemotherapy is associated with side effects and poor prognosis.
Radiation Therapy: Radiation therapy is used to target and shrink tumours in specific areas of the brain. It may be employed as a standalone treatment or in combination with surgery and chemotherapy.
Diagnosis and Treatment: Diagnosing paediatric brain tumours involves a comprehensive evaluation, including the child’s symptoms, imaging scans (like MRI), and examination of a small tissue sample under a microscope.
The chosen treatment method depends on the tumour type, location, the child’s age, and overall health.
Treatment options may involve surgery, radiation, chemotherapy, or a combination of these. The child’s prognosis after treatment can be influenced by several factors, such as the tumour type, its aggressiveness, the child’s age at diagnosis, and the tumour’s location.
Promising Treatments
Quercetin: Quercetin, a bioactive compound derived from various fruits and vegetables, has shown potential in reducing the progression of tumour cells through multitargeted molecular mechanisms.
Recent studies have highlighted quercetin’s anticancer potential in brain tumours, particularly in paediatric cases.
Transmorphic Phage/AAV: A recent study used a tumour-targeted bacteriophage-derived particle, named transmorphic phage/AAV, to deliver a transgene expressing the tumour necrosis factor-alpha (TNFα) for targeted systemic therapy of medulloblastoma, the most common childhood brain tumour.
The vector was engineered to selectively target tumours after intravenous administration, showing promising results in vitro and in vivo, suggesting it could be an effective therapeutic option for paediatric medulloblastoma.
Methylphenidate: Early studies suggest that methylphenidate can benefit cognition and health-related quality of life in paediatric survivors of cancer via improved processing speed and attention.
Paediatric brain tumours present a complex and challenging medical condition for children.
Effective treatment is key to accurate diagnosis, early intervention, and personalised care. Advances in medical science offer promising avenues for better outcomes and a brighter future for children and their families facing this difficult journey.
As we continue to explore innovative therapies and expand our understanding of these tumours, we move closer to providing better care and support for young patients affected by paediatric brain tumours.
References:
- https://www.saudijournals.com/media/articles/SJPM_74_186-192_FT.pdf
- https://www.cancer.gov/rare-brain-spine-tumor/tumors/medulloblastoma
- https://www.cancer.gov/types/brain/hp/child-glioma-treatment-pdq#_1
- https://www.semanticscholar.org/paper/Parental-Perceptions-of-the-Efficacy-of-on-Quality-Smith-Verity/15b3a494c79919d41c9078dd017c82e063d4f4e5
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10057501/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10057501/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10057501/
- https://pubmed.ncbi.nlm.nih.gov/37331004/
- https://pubmed.ncbi.nlm.nih.gov/29980859/