The Role of Age in Pediatric Tumors of the Central Nervous System

Pediatric tumors of the central nervous system (CNS) are the second most common type of solid childhood cancer. As such, they have a major effect on the rates of morbidity and mortality in children. CNS tumors originate from abnormal cells in the brain and/or spinal cord, which can be classified as either benign or malignant. They can be further subdivided into different categories based on several principal aspects, such as tumor location, histopathology, and developmental age. Among these various characteristics, age is one of the most consequential determinants for CNS tumors. Specific groups between 0 and 21 years of age, for instance, have radically divergent landscapes in terms of their tumor incidence and unique biology. Depending on the age of the child, key case features may differ like the clinical evaluation, medical diagnosis and prognosis, recommended therapy and treatment courses, anticipated responses and tolerability to treatment, and management of side effects. Effective teamwork is another crucial component for the successful management of pediatric CNS tumors. In patient-and-family-centered care, ensuring a detailed education of the children and their families, as well as their involvement in the decision-making process where appropriate, is imperative. To determine the best available options for the patient, multidisciplinary medical teams will often deliberate over all of the possible procedures. The holistic care provided by these interprofessional collaborations for this vulnerable population will depend on the age of the child, in addition to the level of patient and family participation. Evidence shows that support and counseling of the patient and their family during the entire treatment process can have a significant impact on outcomes. This chapter will review the essential diagnostic and prognostic considerations of childhood CNS tumors, with special emphasis placed on favorable therapies and treatments, including in-depth discussions around the multi-faceted responses to treatment and the management of its side effects. In particular, this content will highlight the critical role that age, and interdisciplinary healthcare teams play in comprehensive disease management.