Brain stem gliomas: therapeutic options at time of recurrence.

Despite contentions to the contrary, the majority of children with recurrent brain stem gliomas survive for at least 3 months after first relapse. Treatment can be undertaken and response determined, especially if brain stem necrosis is taken into consideration. Relatively few patients have been treated on well-designed studies accruing adequate numbers of patients. No conventional salvage therapy exists. Adequate studies with innovation approaches are needed to help individual patients, families and future generations of children with brain stem gliomas.