Current perspectives on childhood brain tumours: a review

Tumours of the brain and spinal cord are the commonest solid tumour in children and the leading cause of cancer related morbidity and mortality. The increasing availability of modern imaging techniques has resulted in peak of incidences in the 1990s. Current challenges for the general public, paediatricians and general practitioners lie in increasing awareness of the presenting features so that an earlier diagnosis can be made. Specific issues and peculiarities relating to congenital/infantile brain tumours have been explored. Improved histological classification supported by biological markers and subgroup allocation has enabled better treatment planning and increased survival. The emphasis is now focussing on formulating treatment strategies associated with reduced risks of toxicities for favourable risk groups and intensification of treatment for those with worst prognosis. The interface between brain tumours and epilepsy, effects of anti-epileptic medications, antineoplastic medications and tumour surgery on epilepsy were touched upon. Advances in radiotherapy through the increasing availability of proton beam radiotherapy and its advantage over photon radiation therapy in brain tumours has also been discussed.