Fang Francia Y, Rosenblum Jared S, Ho Winson S, Heiss John D
Department of Orthopedics, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA.
Cancers (Basel). 2022 May 3;14(9):2285. doi: 10.3390/cancers14092285.
Pediatric medulloblastoma (MB) is the most common pediatric brain tumor with varying prognoses depending on the distinct molecular subtype. The four consensus subgroups are WNT, Sonic hedgehog (SHH), Group 3, and Group 4, which underpin the current 2021 WHO classification of MB. While the field of knowledge for treating this disease has significantly advanced over the past decade, a deeper understanding is still required to improve the clinical outcomes for pediatric patients, who are often vulnerable in ways that adult patients are not. Here, we discuss how recent insights into the pathogenesis of pediatric medulloblastoma have directed current and future research. This review highlights new developments in understanding the four molecular subtypes' pathophysiology, epigenetics, and therapeutic targeting. In addition, we provide a focused discussion of recent developments in imaging, and in the surgery, chemotherapy, and radiotherapy of pediatric medulloblastoma. The article includes a brief explanation of healthcare costs associated with medulloblastoma treatment.
小儿髓母细胞瘤（MB）是最常见的小儿脑肿瘤，其预后因不同的分子亚型而异。四个共识亚组为WNT、音猬因子（SHH）、3组和4组，这构成了2021年世界卫生组织（WHO）对MB的当前分类基础。尽管在过去十年中治疗这种疾病的知识领域有了显著进展，但仍需要更深入的了解，以改善小儿患者的临床结局，小儿患者往往在一些成年患者不存在的方面较为脆弱。在此，我们讨论了小儿髓母细胞瘤发病机制的最新见解如何指导当前和未来的研究。本综述重点介绍了在理解四种分子亚型的病理生理学、表观遗传学和治疗靶点方面的新进展。此外，我们重点讨论了小儿髓母细胞瘤在影像学以及手术、化疗和放疗方面的最新进展。本文还简要解释了与髓母细胞瘤治疗相关的医疗费用。
