Neurosurgery, San Gerardo Hospital, Monza, Italy.
Department of Medicine and Surgery, School of Medicine, University of Milano-Bicocca, Milan, Italy.
Pediatr Neurosurg. 2022;57(3):149-160. doi: 10.1159/000524165. Epub 2022 Mar 18.
Cervicomedullary gliomas (CMGs) are usually low-grade tumors often found in the pediatric age. Histological findings, treatments, and classification have been much the same for 40 years, although histological and molecular classifications have largely been developed for other pediatric CNS tumors. The management and treatment of pediatric CMG are still conducted by many authors according to their anatomical location and characteristics, independently from histology.
We conducted a literature review in PubMed (Medline) to identify relevant contributions about pediatric CMG published until December 31, 2021. We also analyzed a series of 10 patients with CMG treated from 2006 to 2021 at IRCCS Istituto Nazionale dei Tumori. The aim of the present review was to see whether and how the diagnosis, treatment, and classification of CMGs in children have developed over time, especially in the context of molecular advancements, and to analyze our single-center experience in the last 15 years.
Thirty articles have been included in the review. Articles have been divided into two historical periods (1981-2000 and 2001-2021) and data from different series were analyzed to see how much the management and treatment of pediatric CMG have changed during years. Analysis of our series of 10 patients affected by CMG was also performed to compare it with the literature.
Management and classification of CMG in children have not dramatically changed during years. However, new insight from molecular diagnostics and target therapies and the development of radiological, neurophysiological, and radiotherapy techniques have updated treatment modalities in the last 20 years. Treatment modalities and their innovations have been reviewed and discussed. Further studies are needed to standardize and customize treatment protocols for these tumors.
颈髓胶质瘤（CMG）通常为低级别的肿瘤，常见于儿童期。尽管组织学和分子分类在很大程度上是为其他小儿中枢神经系统肿瘤开发的，但40 年来，CMG 的组织学发现、治疗和分类基本相同。小儿 CMG 的管理和治疗仍由许多作者根据其解剖位置和特征进行，而不考虑组织学。
我们在 PubMed（Medline）上进行了文献回顾，以确定截至 2021 年 12 月 31 日发表的关于小儿 CMG 的相关文献。我们还分析了 2006 年至 2021 年在 IRCCS Istituto Nazionale dei Tumori 治疗的 10 例 CMG 患者的系列。本综述的目的是了解小儿 CMG 的诊断、治疗和分类是否以及如何随着时间的推移而发展，特别是在分子进展的背景下，并分析我们过去 15 年的单中心经验。
共纳入 30 篇文章。将文章分为两个历史时期（1981-2000 年和 2001-2021 年），并分析来自不同系列的数据，以了解小儿 CMG 的管理和治疗在过去几年中发生了多大变化。还对我们的 10 例 CMG 患者系列进行了分析，并与文献进行了比较。
儿童 CMG 的管理和分类多年来没有发生重大变化。然而，分子诊断和靶向治疗的新见解以及放射学、神经生理学和放射治疗技术的发展，在过去 20 年更新了治疗方式。我们回顾和讨论了治疗方式及其创新。需要进一步的研究来为这些肿瘤制定标准化和定制的治疗方案。
