Weiser Annette, Sanchez Bergman Astrid, Machaalani Charbel, Bennett Julie, Roth Patrick, Reimann Regina R, Nazarian Javad, Guerreiro Stucklin Ana S
Translational Brain Tumor Research Group, Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland.
Division of Oncology, University Children's Hospital Zurich, Zurich, Switzerland.
Front Oncol. 2023 Sep 13;13:1254645. doi: 10.3389/fonc.2023.1254645. eCollection 2023.
Gliomas are the most common primary central nervous system (CNS) tumors and a major cause of cancer-related mortality in children (age <15 years), adolescents and young adults (AYA, ages 15-39 years), and adults (age >39 years). Molecular pathology has helped enhance the characterization of these tumors, revealing a heterogeneous and ever more complex group of malignancies. Recent molecular analyses have led to an increased appreciation of common genomic alterations prevalent across all ages. The 2021 World Health Organization (WHO) CNS tumor classification, 5th edition (WHO CNS5) brings forward a nomenclature distinguishing "pediatric-type" and "adult-type" gliomas. The spectrum of gliomas in AYA comprises both "pediatric-like" and "adult-like" tumor entities but remains ill-defined. With fragmentation of clinical management between pediatric and adult centers, AYAs face challenges related to gaps in medical care, lower rates of enrollment in clinical trials and additional psychosocial and economic challenges. This calls for a rethinking of diagnostic and therapeutic approaches, to improve access to appropriate testing and potentially beneficial treatments to patients of all ages.
胶质瘤是最常见的原发性中枢神经系统（CNS）肿瘤，也是儿童（年龄<15岁）、青少年和青年（AYA，年龄15 - 39岁）以及成人（年龄>39岁）癌症相关死亡的主要原因。分子病理学有助于增强对这些肿瘤的特征描述，揭示了一组异质性且日益复杂的恶性肿瘤。最近的分子分析使人们对所有年龄段普遍存在的常见基因组改变有了更多认识。2021年世界卫生组织（WHO）中枢神经系统肿瘤分类第5版（WHO CNS5）提出了一种区分“儿童型”和“成人型”胶质瘤的命名法。AYA患者中的胶质瘤谱系包括“儿童样”和“成人样”肿瘤实体，但仍定义不明确。由于儿科和成人中心之间临床管理的碎片化，AYA患者面临着与医疗服务差距、临床试验入组率较低以及额外的心理社会和经济挑战相关的问题。这就需要重新思考诊断和治疗方法，以改善所有年龄段患者获得适当检测和潜在有益治疗的机会。
