Pediatric Intracranial Neoplasms of the Posterior Fossa

ABSTRACT

-Pediatric posterior fossa tumors are comprised of a variety of tumors with a wide spectrum of biological behaviors. The majority of these neoplasms are made up of primitive neuroectodermal tumors (medulloblastomas), astrocytomas, pilocytic astrocytomas, and ependymomas. Improvements in surgical technique, adjunctive therapy, patient follow-up, and imaging have resulted in increased long-term survival of patients with most of these neoplasms, with the exception of anaplastic astrocytomas and glioblastomas.

In addition to these general improvements in management, specific factors have been found to affect survival and functional outcomes of these patients. Age greater than 3 years of age, the absence of metastatic disease at presentation, the extent of resection, radiation therapy, and chemotherapy in certain tumors have been associated with improved survival of these patients. Acknowledgment of the severe detrimental effects of radiation on the development of children less than 3 years of age has resulted in an emphasis on surgery and chemotherapy for these patients, with radiation reserved for those who fail these modalities. Several clinical trials are in progress to further define the safest and most effective protocols for these and other patients with posterior fossa tumors.

KEYWORD

Pediatric intracranial neoplasms - medulloblastoma ependymoma - cerebellar astrocytoma