State of the art chemotherapeutic management of pediatric brain tumors.

CNS tumors are the most common solid tumor of childhood. This article will review current treatments for pediatric brain tumors; low-grade gliomas, high-grade gliomas, medulloblastomas and ependymomas. It will also highlight the treatments that are used for brain tumors in very young children and in children with recurrent brain tumors. The management of recurrent pediatric brain tumors unresponsive to standard therapy will be discussed. The agents used in this setting are mainly biological modifiers, which attempt to provide molecularly targeted therapy. Future directions of therapy for pediatric brain tumors are described. Future treatment paradigms will need to consider examining the use of multiple biological modifiers. Similarly, these agents will need to be examined in combination with cytotoxic chemotherapy. Finally, the future direction of pediatric neuro-oncology and the focus of the field as it battles pediatric brain tumors is discussed.