Biological Markers in Pediatric Brain Tumors

The most common solid tumors in children are brain tumors1. Yearly, approximately 2-2.5 per 100,000 children of <15 years of age are diagnosed with a brain tumor1. Despite improved survival rates, brain tumors in children are still the second leading cause of death due to cancer in children. Moreover, serious long-term side effects due to the localization of the tumor and due to treatment result in a considerable decrease in the quality of life in surviving patients. Pediatric brain tumors differ from those arising in adults in localization, histology and responsiveness to therapy2, 3. Approximately 50% of the brain tumors in childhood are found infratentorial, whereas most of the tumors in adults arise in and around the cerebral hemispheres3. Regarding histology, embryonal central nervous system (CNS) tumors are almost solely found in children, whereas meningeomas and metastases to the brain predominantly arise in adults and are rare in children (Table 1). Astrocytic tumors are the most frequent brain tumors in children (~25%). This group of tumors comprises a wide range of clinically, histologically and biologically distinct subtypes4. In children, the most common subtype is the grade I pilocytic astrocytoma, whereas grade III anaplastic astrocytoma and grade IV glioblastoma predominate in adults. Unlike adults, children frequently develop malignant glioma within the brainstem, which is associated with a very poor prognosis due to the limited treatment options5.

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