Duffner P K, Cohen M E
Department of Neurology, SUNY at Buffalo School of Medicine, Children's Hospital.
Pediatr Neurosci. 1985;12(6):304-10. doi: 10.1159/000120271.
Approximately 13% of brain tumors in childhood occur in children less than 2 years of age. Although the survivals of older children with certain forms of brain tumors have increased over the past 20 years, this treatment has been least effective in very young children with brain tumors. These poor survival rates may be due in part to the highly malignant nature of the neoplasms; the delay in diagnosis because of low index of suspicion; the large bulk of tumor found at presentation, and the reduction in radiation dosage to the central nervous system. Since standard treatment has produced both poor results and severe neurotoxicity, new approaches have been sought. A conservative approach is recommended in some children with optic gliomas and low-grade supratentorial astrocytomas. Radiation is deferred until the child reaches 3-4 years of age when he can better tolerate its effects on the CNS. Current therapy of malignant brain tumors of infancy is not only toxic, but inadequate. There are several centers which currently use postoperative chemotherapy and delayed radiation. Early results have been encouraging and neurotoxicity has been low.
约13%的儿童脑肿瘤发生在2岁以下的儿童中。尽管在过去20年里，某些类型脑肿瘤的大龄儿童生存率有所提高，但这种治疗方法对患有脑肿瘤的幼儿效果最差。这些低生存率可能部分归因于肿瘤的高度恶性本质；由于怀疑指数低导致诊断延迟；就诊时发现的肿瘤体积大，以及中枢神经系统辐射剂量的减少。由于标准治疗效果不佳且会产生严重的神经毒性，因此一直在寻求新的治疗方法。对于一些患有视神经胶质瘤和幕上低级星形细胞瘤的儿童，建议采用保守治疗方法。放疗推迟到孩子3 - 4岁时进行，此时他能更好地耐受放疗对中枢神经系统的影响。目前婴儿恶性脑肿瘤的治疗不仅有毒性，而且效果不佳。目前有几个中心采用术后化疗和延迟放疗。早期结果令人鼓舞，神经毒性较低。
