Introduction to the Special Issue on Pediatric Neuro-Oncology

Pediatric Neuro-Oncology is a highly specialized field encompassing molecular biology, clinical acumen, evidence based medicine, cancer genetics and neuropsychological care for the diagnosis and treatment of children with central nervous system (CNS) tumors. [...

Update in Pediatric Neuro-Oncology

This Special Issue of Bioengineering explores topics in Pediatric Neuro-Oncology ranging from preclinical modeling to translational research and neurocognitive outcomes. The topics are as below. 1. Radiotherapy advances in pediatric brain tumors; 2. Neurofibromatosis 1 and brain tumors in children; 3. Molecular biology of pediatric gliomas and therapeutic insights; 4. Embryonal tumors of the central nervous system in children-era of targeted therapeutics; 5. Preclinical models in pediatric brain tumors—clinical relevance; 6. Molecular neuroimaging of brain tumors; 7. Palliative care for children with central nervous system malignancies; 8. Neurocognitive and psychosocial outcomes following pediatric brain tumors

Morning glory disc anomaly and ipsilateral sporadic optic pathway glioma

Purpose: To present a rare case of morning glory disc anomaly in association with an ipsilateral low grade glioma. Observations: A 5 year old male presented with a unilateral morning glory disc anomaly and an ipsilateral sporadic optic pathway glioma with chiasmal involvement. After a strict patching regimen his vision improved from 20/400 to 20/80. Conclusions and importance: This report strengthens the recommendation for brain magnetic resonance imaging in patients with morning glory disc anomaly. Patching of the contralateral eye should be attempted since the role of amblyopia may be significant. Keywords: Morning glory disc anomaly, Optic pathway glioma, Magnetic resonance imaging, Amblyopi

Evaluating Focal Areas of Signal Intensity (FASI) in Children with Neurofibromatosis Type-1 (NF1) Treated with Selumetinib on Pediatric Brain Tumor Consortium (PBTC)-029B

Background: Understanding the effect of selumetinib on FASI may help elucidate the biology, proliferative potential, and role in neurocognitive changes for these NF1-associated lesions. Methods: Patients with NF1-associated LGG and FASI treated with selumetinib on PBTC-029B were age-matched to untreated patients with NF1-associated FASI at Cincinnati Children’s Hospital Medical Center. Paired bidirectional measurements were compared over time using nonparametric tests. Results: Sixteen age-matched pairs were assessed (age range: 2.8–16.9 years, 60% male). Initial FASI burden was not different between groups (median range 138.7 cm2 [88.4–182.0] for the treated subjects vs. 121.6 cm2 [79.6—181.9] for the untreated subjects; p = 0.98). Over a mean follow-up of 18.9 (±5.9) months, the LGG size consistently decreased with treatment while no consistent change among the treated or untreated FASI size was seen. At the paired time points, the median treated LGG decreased significantly more than the treated FASI (−41.3% (LGG) versus −10.7% (FASI), p = 0.006). However, there was no difference in the median size change in the treated versus untreated FASI (−10.7% (treated FASI) versus −17.9% (untreated FASI), p = 0.08). Among the treated subjects, there was no correlation between the change in LGG and FASI (r = −0.04, p = 0.88). Conclusions: Treatment with selumetinib did not affect the overall FASI size in children with NF1 treated for progressive low-grade glioma

Neurocognitive and Psychosocial Outcomes in Pediatric Brain Tumor Survivors

The late neurocognitive and psychosocial effects of treatment for pediatric brain tumor (PBT) represent important areas of clinical focus and ongoing research. Neurocognitive sequelae and associated problems with learning and socioemotional development negatively impact PBT survivors’ overall health-related quality of life, educational attainment and employment rates. Multiple factors including tumor features and associated complications, treatment methods, individual protective and vulnerability factors and accessibility of environmental supports contribute to the neurocognitive and psychosocial outcomes in PBT survivors. Declines in overall measured intelligence are common and may persist years after treatment. Core deficits in attention, processing speed and working memory are postulated to underlie problems with overall intellectual development, academic achievement and career attainment. Additionally, psychological problems after PBT can include depression, anxiety and psychosocial adjustment issues. Several intervention paradigms are briefly described, though to date research on innovative, specific and effective interventions for neurocognitive late effects is still in its early stages. This article reviews the existing research for understanding PBT late effects and highlights the need for innovative research to enhance neurocognitive and psychosocial outcomes in PBT survivors