首页 > 最新文献

Seminars in Pediatric Neurology最新文献

英文 中文
Endocrine manifestations of pediatric CNS tumors at diagnosis and as sequalae of treatment 小儿中枢神经系统肿瘤诊断时及治疗后的内分泌表现
IF 2.4 4区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2025-04-01 DOI: 10.1016/j.spen.2025.101184
Sara Velasquez Restrepo , Zoltan Antal
Pediatric CNS tumors may be associated with endocrinopathies at the time of initial diagnosis and as a sequalae of their treatment. Endocrine dysfunction is highly prevalent among tumors located along the hypothalamic pituitary axis and optic pathway, with manifestations such as precocious puberty, diabetes insipidus, or growth failure presenting initially without neurologic symptoms. Posterior fossa tumors, which are more common in pediatrics, can also present with endocrine dysfunction despite their relatively more distant location due to their propensity for causing hydrocephalus. The various treatment modalities for CNS tumors portend additional risks for developing endocrinopathies. Acute endocrine dysfunction often follows surgery involving the HP axis, while endocrine late effects, particularly following radiation exposure of the HP axis, can develop more insidiously years to decades after completion of treatment. Chemotherapy and newer targeted and immunotherapies can cause peripheral endocrine gland as well as HP axis dysfunction. With an increasing number of childhood cancer survivors in the population, recognition and treatment of endocrine late effects is increasingly important. We review here the common endocrine dysfunction associated with various CNS tumors at diagnosis and as a consequence of their treatment.
小儿中枢神经系统肿瘤在最初诊断时可能与内分泌病变有关,并作为其治疗的后遗症。内分泌功能障碍在沿下丘脑垂体轴和视神经通路的肿瘤中非常普遍,表现为性早熟、尿崩症或生长衰竭,最初无神经系统症状。后窝肿瘤在儿科中更为常见,尽管其位置相对较远,但由于其易引起脑积水,也可表现为内分泌功能障碍。中枢神经系统肿瘤的各种治疗方式预示着发生内分泌疾病的额外风险。急性内分泌功能障碍常发生在涉及HP轴的手术后,而内分泌晚期效应,特别是HP轴辐射暴露后,可在治疗完成后数年至数十年更加隐蔽地发展。化疗和新的靶向和免疫治疗可引起外周内分泌腺和HP轴功能障碍。随着儿童癌症幸存者人数的增加,认识和治疗内分泌晚期效应变得越来越重要。我们在此回顾与各种中枢神经系统肿瘤诊断和治疗相关的常见内分泌功能障碍。
{"title":"Endocrine manifestations of pediatric CNS tumors at diagnosis and as sequalae of treatment","authors":"Sara Velasquez Restrepo ,&nbsp;Zoltan Antal","doi":"10.1016/j.spen.2025.101184","DOIUrl":"10.1016/j.spen.2025.101184","url":null,"abstract":"<div><div>Pediatric CNS tumors may be associated with endocrinopathies at the time of initial diagnosis and as a sequalae of their treatment. Endocrine dysfunction is highly prevalent among tumors located along the hypothalamic pituitary axis and optic pathway, with manifestations such as precocious puberty, diabetes insipidus, or growth failure presenting initially without neurologic symptoms. Posterior fossa tumors, which are more common in pediatrics, can also present with endocrine dysfunction despite their relatively more distant location due to their propensity for causing hydrocephalus. The various treatment modalities for CNS tumors portend additional risks for developing endocrinopathies. Acute endocrine dysfunction often follows surgery involving the HP axis, while endocrine late effects, particularly following radiation exposure of the HP axis, can develop more insidiously years to decades after completion of treatment. Chemotherapy and newer targeted and immunotherapies can cause peripheral endocrine gland as well as HP axis dysfunction. With an increasing number of childhood cancer survivors in the population, recognition and treatment of endocrine late effects is increasingly important. We review here the common endocrine dysfunction associated with various CNS tumors at diagnosis and as a consequence of their treatment.</div></div>","PeriodicalId":49284,"journal":{"name":"Seminars in Pediatric Neurology","volume":"53 ","pages":"Article 101184"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143808348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Social challenges and isolation in pediatric brain tumor survivors: A comprehensive review of psychosocial and cognitive factors 儿童脑肿瘤幸存者的社会挑战和孤立:心理社会和认知因素的综合综述
IF 2.4 4区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2025-04-01 DOI: 10.1016/j.spen.2025.101180
Karen L. Long Traynor , Jennifer J. Boughton , Karishma M. Parikh
Pediatric brain tumor survivors (PBTS) face social, emotional, and cognitive challenges that significantly impact their quality of life. While survival rates have improved due to advances in medical treatments, PBTS are often at a heightened risk for social isolation and difficulties forming and maintaining peer relationships. In this review, we synthesize existing research on the social and cognitive struggles faced by PBTS and the challenges they face forming meaningful, reciprocal friendships. PBTS often have cognitive deficits that hinder their ability to recognize social cues and are at risk of bullying and teasing from peers, which can lead to further social isolation. The role of family support is critical, with strong family bonds serving as an essential protective factor. Social skills interventions have shown promise, yet further research is needed to understand how these interventions can effectively increase the social performance of PBTS with their peers.
儿童脑肿瘤幸存者(PBTS)面临着社会、情感和认知方面的挑战,这些挑战显著影响了他们的生活质量。虽然由于医学治疗的进步,存活率有所提高,但PBTS往往面临更大的社会孤立风险,难以形成和维持同伴关系。在这篇综述中,我们综合了关于PBTS面临的社会和认知斗争以及他们在建立有意义的互惠友谊方面面临的挑战的现有研究。PBTS通常有认知缺陷,这阻碍了他们识别社交线索的能力,并有被同龄人欺凌和戏弄的风险,这可能导致进一步的社会孤立。家庭支持的作用至关重要,牢固的家庭纽带是必不可少的保护因素。社会技能干预已经显示出了希望,但需要进一步的研究来了解这些干预如何有效地提高PBTS与同龄人的社会表现。
{"title":"Social challenges and isolation in pediatric brain tumor survivors: A comprehensive review of psychosocial and cognitive factors","authors":"Karen L. Long Traynor ,&nbsp;Jennifer J. Boughton ,&nbsp;Karishma M. Parikh","doi":"10.1016/j.spen.2025.101180","DOIUrl":"10.1016/j.spen.2025.101180","url":null,"abstract":"<div><div>Pediatric brain tumor survivors (PBTS) face social, emotional, and cognitive challenges that significantly impact their quality of life. While survival rates have improved due to advances in medical treatments, PBTS are often at a heightened risk for social isolation and difficulties forming and maintaining peer relationships. In this review, we synthesize existing research on the social and cognitive struggles faced by PBTS and the challenges they face forming meaningful, reciprocal friendships. PBTS often have cognitive deficits that hinder their ability to recognize social cues and are at risk of bullying and teasing from peers, which can lead to further social isolation. The role of family support is critical, with strong family bonds serving as an essential protective factor. Social skills interventions have shown promise, yet further research is needed to understand how these interventions can effectively increase the social performance of PBTS with their peers.</div></div>","PeriodicalId":49284,"journal":{"name":"Seminars in Pediatric Neurology","volume":"53 ","pages":"Article 101180"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143808350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pediatric CNS tumors: Overview and treatment paradigms 小儿中枢神经系统肿瘤:概述和治疗范例
IF 2.4 4区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2025-04-01 DOI: 10.1016/j.spen.2025.101186
Karishma Parikh , Sameer Farouk Sait
Central nervous system (CNS) tumors represent the most common solid tumors occurring in children, with gliomas, medulloblastomas and ependymomas being the most frequently diagnosed. The most recent 2021 World Health Organization (WHO) Classification of Tumors of the CNS (CNS5) has integrated molecular genetics with traditional histopathology leading to more accurate diagnosis and risk stratification/prognostication with subsequent development of personalized treatment paradigms. Pediatric gliomas are traditionally subdivided into low-grade (pLGG) or high-grade gliomas (pHGG). pLGG tend to have excellent overall survival, however, the disease course maybe characterized by multiple recurrences resulting in significant morbidity. Surgical resection is standard with medical therapy (chemotherapy or oral molecular targeted therapy) reserved in the event of radiographic/symptomatic progression. pHGG have poor overall survival despite intensive multimodality therapy. Ependymomas occur in the infratentorial and supratentorial brain as well as in the spine, with the standard treatment including maximal safe resection with involved field radiation therapy that is curative in two-thirds of patients overall. Medulloblastomas are the most common malignant embryonal CNS tumor arising in the cerebellum and are biologically heterogeneous. Given the risk of CSF dissemination, medulloblastomas require surgery, craniospinal radiation as well as multi agent chemotherapy, an approach that is curative in the majority of patients with non-metastatic disease. The field of pediatric neuro-oncology has made robust strides in the past few decades and the role of molecular diagnostics has continued to improve our understanding of pediatric tumor biology and offer more personalized treatment paradigms.
中枢神经系统(CNS)肿瘤是儿童中最常见的实体肿瘤,胶质瘤、髓母细胞瘤和室管膜瘤是最常见的诊断。最新的2021年世界卫生组织(WHO)中枢神经系统肿瘤分类(CNS5)将分子遗传学与传统组织病理学相结合,导致更准确的诊断和风险分层/预后,随后发展个性化治疗模式。小儿胶质瘤传统上分为低级别胶质瘤(pLGG)和高级胶质瘤(pHGG)。pLGG往往有很好的总生存率,然而,病程可能以多次复发为特征,导致显著的发病率。手术切除是标准的药物治疗(化疗或口服分子靶向治疗)保留在放射学/症状进展的情况下。尽管进行了强化的多模式治疗,但pHGG的总生存率较差。室管膜瘤发生于幕下和幕上脑以及脊柱,标准治疗包括最大安全切除和受病灶放射治疗,总治愈率为三分之二。髓母细胞瘤是发生在小脑的最常见的恶性胚胎性中枢神经系统肿瘤,具有生物学异质性。考虑到脑脊液播散的风险,髓母细胞瘤需要手术、颅脊髓放射以及多药化疗,这种方法在大多数非转移性疾病患者中是可以治愈的。在过去的几十年里,儿童神经肿瘤学领域取得了长足的进步,分子诊断的作用不断提高我们对儿童肿瘤生物学的理解,并提供了更多个性化的治疗范例。
{"title":"Pediatric CNS tumors: Overview and treatment paradigms","authors":"Karishma Parikh ,&nbsp;Sameer Farouk Sait","doi":"10.1016/j.spen.2025.101186","DOIUrl":"10.1016/j.spen.2025.101186","url":null,"abstract":"<div><div>Central nervous system (CNS) tumors represent the most common solid tumors occurring in children, with gliomas, medulloblastomas and ependymomas being the most frequently diagnosed. The most recent 2021 World Health Organization (WHO) Classification of Tumors of the CNS (CNS5) has integrated molecular genetics with traditional histopathology leading to more accurate diagnosis and risk stratification/prognostication with subsequent development of personalized treatment paradigms. Pediatric gliomas are traditionally subdivided into low-grade (pLGG) or high-grade gliomas (pHGG). pLGG tend to have excellent overall survival, however, the disease course maybe characterized by multiple recurrences resulting in significant morbidity. Surgical resection is standard with medical therapy (chemotherapy or oral molecular targeted therapy) reserved in the event of radiographic/symptomatic progression. pHGG have poor overall survival despite intensive multimodality therapy. Ependymomas occur in the infratentorial and supratentorial brain as well as in the spine, with the standard treatment including maximal safe resection with involved field radiation therapy that is curative in two-thirds of patients overall. Medulloblastomas are the most common malignant embryonal CNS tumor arising in the cerebellum and are biologically heterogeneous. Given the risk of CSF dissemination, medulloblastomas require surgery, craniospinal radiation as well as multi agent chemotherapy, an approach that is curative in the majority of patients with non-metastatic disease. The field of pediatric neuro-oncology has made robust strides in the past few decades and the role of molecular diagnostics has continued to improve our understanding of pediatric tumor biology and offer more personalized treatment paradigms.</div></div>","PeriodicalId":49284,"journal":{"name":"Seminars in Pediatric Neurology","volume":"53 ","pages":"Article 101186"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143808412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Neurological sequalae in pediatric patients with CNS tumors after radiation treatment: A comprehensive review 小儿中枢神经系统肿瘤放射治疗后的神经系统后遗症:综合综述
IF 2.4 4区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2025-04-01 DOI: 10.1016/j.spen.2025.101181
Ritesh Kumar, Lakshmi Rekha Narra, Zohaib Sherwani, Rahul R Parikh
Radiation therapy plays a pivotal role in treating pediatric central nervous system (CNS) tumors. However, its potential long-term impact on neurological function poses significant challenges. In this review, we examine the scope of neurological sequelae in survivors of pediatric CNS tumors, with a focus on clinical manifestations, evaluation methods, and management strategies. Key areas discussed include neurocognitive deficits, endocrine dysfunctions, cerebrovascular complications, and secondary malignancies. Emphasis is placed on mitigating radiation-induced toxicity through advanced radiotherapy techniques and integrated survivorship care.
放射治疗在小儿中枢神经系统(CNS)肿瘤的治疗中起着关键作用。然而,它对神经功能的潜在长期影响带来了重大挑战。在这篇综述中,我们研究了小儿中枢神经系统肿瘤幸存者的神经系统后遗症的范围,重点是临床表现、评估方法和管理策略。讨论的主要领域包括神经认知缺陷、内分泌功能障碍、脑血管并发症和继发性恶性肿瘤。重点是通过先进的放射治疗技术和综合生存护理来减轻辐射引起的毒性。
{"title":"Neurological sequalae in pediatric patients with CNS tumors after radiation treatment: A comprehensive review","authors":"Ritesh Kumar,&nbsp;Lakshmi Rekha Narra,&nbsp;Zohaib Sherwani,&nbsp;Rahul R Parikh","doi":"10.1016/j.spen.2025.101181","DOIUrl":"10.1016/j.spen.2025.101181","url":null,"abstract":"<div><div>Radiation therapy plays a pivotal role in treating pediatric central nervous system (CNS) tumors. However, its potential long-term impact on neurological function poses significant challenges. In this review, we examine the scope of neurological sequelae in survivors of pediatric CNS tumors, with a focus on clinical manifestations, evaluation methods, and management strategies. Key areas discussed include neurocognitive deficits, endocrine dysfunctions, cerebrovascular complications, and secondary malignancies. Emphasis is placed on mitigating radiation-induced toxicity through advanced radiotherapy techniques and integrated survivorship care.</div></div>","PeriodicalId":49284,"journal":{"name":"Seminars in Pediatric Neurology","volume":"53 ","pages":"Article 101181"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143808349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Low-grade epilepsy-associated tumors in pediatric patients: A focused review of the tumor differential and current treatment options 儿科患者低级别癫痫相关肿瘤:肿瘤鉴别和当前治疗方案的重点回顾
IF 2.4 4区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2025-04-01 DOI: 10.1016/j.spen.2025.101188
Angela M Curcio
Seizures associated with low-grade tumors in pediatric patients can be drug resistant and associated with significant morbidity. There are several low-grade tumor types associated with epilepsy in this population with the majority localized to the temporal lobe and some extra-temporal locations (frontal, parietal, and occipital lobes). The primary treatment of low-grade epilepsy-associated tumors is surgical resection, though the surgical approach and the use of intraoperative techniques remain controversial. Newer treatments are under investigation as primary and/or adjunctive therapy, including non-invasive surgical options and gene-targeted therapy. A multimodal approach to treatment may improve long-term outcomes and quality of life.
小儿低级别肿瘤患者的癫痫发作可能具有耐药性,并伴有显著的发病率。在这一人群中有几种与癫痫相关的低级别肿瘤类型,大多数定位于颞叶和一些颞外位置(额叶、顶叶和枕叶)。低级别癫痫相关肿瘤的主要治疗是手术切除,尽管手术入路和术中技术的使用仍存在争议。目前正在研究新的治疗方法作为主要和/或辅助治疗,包括非侵入性手术选择和基因靶向治疗。多模式治疗可以改善长期预后和生活质量。
{"title":"Low-grade epilepsy-associated tumors in pediatric patients: A focused review of the tumor differential and current treatment options","authors":"Angela M Curcio","doi":"10.1016/j.spen.2025.101188","DOIUrl":"10.1016/j.spen.2025.101188","url":null,"abstract":"<div><div>Seizures associated with low-grade tumors in pediatric patients can be drug resistant and associated with significant morbidity. There are several low-grade tumor types associated with epilepsy in this population with the majority localized to the temporal lobe and some extra-temporal locations (frontal, parietal, and occipital lobes). The primary treatment of low-grade epilepsy-associated tumors is surgical resection, though the surgical approach and the use of intraoperative techniques remain controversial. Newer treatments are under investigation as primary and/or adjunctive therapy, including non-invasive surgical options and gene-targeted therapy. A multimodal approach to treatment may improve long-term outcomes and quality of life.</div></div>","PeriodicalId":49284,"journal":{"name":"Seminars in Pediatric Neurology","volume":"53 ","pages":"Article 101188"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143808415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Whole-tissue and autologous dendritic cell vaccines in pediatric brain tumors: A focused review of current evidence and future directions 儿童脑肿瘤的全组织和自体树突状细胞疫苗:当前证据和未来方向的重点回顾
IF 2.4 4区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2025-04-01 DOI: 10.1016/j.spen.2025.101183
Garrett Gianneschi , Rohan Hublikar , Jason Sherman , Harini Rao

Introduction

Cancer immunotherapy is becoming increasingly personalized, and autologous therapeutic vaccines (ATVs) represent a promising strategy by leveraging patient-derived tumor antigens. Two main types, whole-tissue autologous therapeutic vaccines (WATVs) and autologous dendritic cell vaccines (ADCVs), have demonstrated safety and efficacy in adult oncology. However, their application in pediatric neuro-oncology remains underexplored.

Objective

To review recent clinical advancements in the use of WATVs and ADCVs for pediatric brain tumors, focusing on safety, feasibility, and preliminary outcomes.

Methods

A systematic search of studies (2004–2025) was conducted using PubMed, Scopus, EMBASE, Cochrane, and clinical trial registries. Inclusion criteria were pediatric brain tumor studies involving WATVs or ADCVs. Studies were assessed per PRISMA guidelines, biases were addressed and outcome data were synthesized narratively using pooled patient data.

Results

WATVs had no dedicated pediatric brain tumor studies. However, a subgroup analysis in a mixed ADCV-WATV trial for pediatric brain tumors (n = 26) was performed showing safety and feasibility. For ADCVs, seven clinical trials with (n = 85) met inclusion criteria. ADCVs demonstrated a strong safety profile, with no treatment-related deaths and only one severe adverse event. Progression-free survival ranged from 1.4 to 85.6 months, and overall survival ranged from 1.4 to 143 months. Factors improving outcomes included gross total resection and newly diagnosed high-grade gliomas. Production time for vaccines posed a feasibility challenge.

Conclusion

WATVs and ADCVs are safe but underutilized in pediatric neuro-oncology. ADCVs, in particular, have shown potential for high-grade gliomas and atypical teratoid rhabdoid tumors. Future studies should optimize vaccine production timelines and evaluate the efficacy of various antigenic materials. Phase III trials are needed to establish clinical benefit.
癌症免疫治疗正变得越来越个性化,而利用患者来源的肿瘤抗原的自体治疗性疫苗(ATVs)是一种很有前途的策略。两种主要类型,全组织自体治疗性疫苗(WATVs)和自体树突状细胞疫苗(adcv),已经证明在成人肿瘤治疗中的安全性和有效性。然而,它们在小儿神经肿瘤学中的应用仍未得到充分探索。目的综述WATVs和adcv治疗小儿脑肿瘤的临床进展,重点分析其安全性、可行性和初步疗效。方法采用PubMed、Scopus、EMBASE、Cochrane和临床试验注册数据库系统检索2004-2025年的相关研究。纳入标准是涉及WATVs或adcv的儿童脑肿瘤研究。根据PRISMA指南对研究进行评估,解决偏倚问题,并使用汇总的患者数据对结果数据进行叙述性综合。结果watvs没有专门的儿童脑肿瘤研究。然而,一项针对儿童脑肿瘤的ADCV-WATV混合试验(n = 26)的亚组分析显示了安全性和可行性。对于adcv,有7项临床试验(n = 85)符合纳入标准。adcv显示出很强的安全性,没有与治疗相关的死亡,只有一个严重不良事件。无进展生存期为1.4至85.6个月,总生存期为1.4至143个月。改善预后的因素包括大体全切除和新诊断的高级别胶质瘤。疫苗的生产时间对可行性提出了挑战。结论watvs和adcv在小儿神经肿瘤治疗中是安全的,但未得到充分利用。特别是ADCVs,已经显示出高级别胶质瘤和非典型畸胎瘤样横纹肌样肿瘤的潜力。未来的研究应优化疫苗生产时间表,并评估各种抗原材料的功效。需要III期试验来确定临床效益。
{"title":"Whole-tissue and autologous dendritic cell vaccines in pediatric brain tumors: A focused review of current evidence and future directions","authors":"Garrett Gianneschi ,&nbsp;Rohan Hublikar ,&nbsp;Jason Sherman ,&nbsp;Harini Rao","doi":"10.1016/j.spen.2025.101183","DOIUrl":"10.1016/j.spen.2025.101183","url":null,"abstract":"<div><h3>Introduction</h3><div>Cancer immunotherapy is becoming increasingly personalized, and autologous therapeutic vaccines (ATVs) represent a promising strategy by leveraging patient-derived tumor antigens. Two main types, whole-tissue autologous therapeutic vaccines (WATVs) and autologous dendritic cell vaccines (ADCVs), have demonstrated safety and efficacy in adult oncology. However, their application in pediatric neuro-oncology remains underexplored.</div></div><div><h3>Objective</h3><div>To review recent clinical advancements in the use of WATVs and ADCVs for pediatric brain tumors, focusing on safety, feasibility, and preliminary outcomes.</div></div><div><h3>Methods</h3><div>A systematic search of studies (2004–2025) was conducted using PubMed, Scopus, EMBASE, Cochrane, and clinical trial registries. Inclusion criteria were pediatric brain tumor studies involving WATVs or ADCVs. Studies were assessed per PRISMA guidelines, biases were addressed and outcome data were synthesized narratively using pooled patient data.</div></div><div><h3>Results</h3><div>WATVs had no dedicated pediatric brain tumor studies. However, a subgroup analysis in a mixed ADCV-WATV trial for pediatric brain tumors (<em>n</em> = 26) was performed showing safety and feasibility. For ADCVs, seven clinical trials with (<em>n</em> = 85) met inclusion criteria. ADCVs demonstrated a strong safety profile, with no treatment-related deaths and only one severe adverse event. Progression-free survival ranged from 1.4 to 85.6 months, and overall survival ranged from 1.4 to 143 months. Factors improving outcomes included gross total resection and newly diagnosed high-grade gliomas. Production time for vaccines posed a feasibility challenge.</div></div><div><h3>Conclusion</h3><div>WATVs and ADCVs are safe but underutilized in pediatric neuro-oncology. ADCVs, in particular, have shown potential for high-grade gliomas and atypical teratoid rhabdoid tumors. Future studies should optimize vaccine production timelines and evaluate the efficacy of various antigenic materials. Phase III trials are needed to establish clinical benefit.</div></div>","PeriodicalId":49284,"journal":{"name":"Seminars in Pediatric Neurology","volume":"53 ","pages":"Article 101183"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143808351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Foreword to pediatric CNS Tumors: Clinical presentation, management and sequalae 小儿中枢神经系统肿瘤:临床表现、处理和后遗症
IF 2.4 4区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2025-04-01 DOI: 10.1016/j.spen.2025.101189
Karishma Parikh
{"title":"Foreword to pediatric CNS Tumors: Clinical presentation, management and sequalae","authors":"Karishma Parikh","doi":"10.1016/j.spen.2025.101189","DOIUrl":"10.1016/j.spen.2025.101189","url":null,"abstract":"","PeriodicalId":49284,"journal":{"name":"Seminars in Pediatric Neurology","volume":"53 ","pages":"Article 101189"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143808411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pediatric headache attributed to brain tumor 小儿头痛归因于脑肿瘤
IF 2.4 4区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2025-04-01 DOI: 10.1016/j.spen.2025.101185
Zuhal Ergonul , Amelia Stone
Headache is one of the most common neurologic disorders in children with a prevalence between 57-82 %. Affecting only 2.5 per 100,000 persons of the pediatric population, brain tumors in children is less common, but frequently present with headache. However, headache rarely presents as the sole neurologic symptom of a brain tumor in children. According to the International Classification of Headache Disorders Third Edition (ICHD-3), a headache may be attributed to a brain tumor if it is in close temporal relation with the tumor, worsens in parallel with the tumor, and/or improves after the successful treatment of the tumor. Brain tumor headaches are traditionally thought to display specific characteristics, including severe pain intensity, morning occurrence and association with nausea or vomiting. There are no formal criteria for headache attributed to brain tumor in children in ICHD-3. In this review we provide an overview of the ICHD-3 criteria and clinical presentation, and management of headaches attributed to brain tumors in children.
头痛是儿童中最常见的神经系统疾病之一,患病率在57- 82%之间。儿童脑瘤发病率仅为每10万人2.5人,发病率较低,但常伴有头痛。然而,头痛很少表现为儿童脑肿瘤的唯一神经系统症状。根据国际头痛疾病分类第三版(ICHD-3),如果头痛与肿瘤有密切的时间关系,与肿瘤同时恶化,和/或在肿瘤治疗成功后好转,则头痛可能归因于脑肿瘤。脑瘤性头痛通常被认为具有特定的特征,包括剧烈的疼痛强度、早晨发作以及伴有恶心或呕吐。在ICHD-3患儿中,由于脑肿瘤引起的头痛没有正式的标准。在这篇综述中,我们提供了ICHD-3标准和临床表现的概述,以及儿童脑肿瘤引起的头痛的处理。
{"title":"Pediatric headache attributed to brain tumor","authors":"Zuhal Ergonul ,&nbsp;Amelia Stone","doi":"10.1016/j.spen.2025.101185","DOIUrl":"10.1016/j.spen.2025.101185","url":null,"abstract":"<div><div>Headache is one of the most common neurologic disorders in children with a prevalence between 57-82 %. Affecting only 2.5 per 100,000 persons of the pediatric population, brain tumors in children is less common, but frequently present with headache. However, headache rarely presents as the sole neurologic symptom of a brain tumor in children. According to the International Classification of Headache Disorders Third Edition (ICHD-3), a headache may be attributed to a brain tumor if it is in close temporal relation with the tumor, worsens in parallel with the tumor, and/or improves after the successful treatment of the tumor. Brain tumor headaches are traditionally thought to display specific characteristics, including severe pain intensity, morning occurrence and association with nausea or vomiting. There are no formal criteria for headache attributed to brain tumor in children in ICHD-3. In this review we provide an overview of the ICHD-3 criteria and clinical presentation, and management of headaches attributed to brain tumors in children.</div></div>","PeriodicalId":49284,"journal":{"name":"Seminars in Pediatric Neurology","volume":"53 ","pages":"Article 101185"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143808413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Ataxia telangiectasia
IF 2.4 4区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-12-01 DOI: 10.1016/j.spen.2024.101169
John Collyer, Deepa S Rajan
Ataxia telangiectasia (AT) is a rare neurocutaneous syndrome that results from biallelic pathogenic variants in the ataxia telangiectasia mutated (ATM) gene, named for its characteristic cerebellar ataxia in the early toddler years and variable oculocutaneous telangiectasias in the school age years. While its name only hints at neurologic and cutaneous manifestations, this multisystemic disorder also has important immunologic, oncologic, respiratory, and endocrinologic implications. This article will review the function of the ATM gene, the neurologic manifestations of AT, non-neurologic complications, mimickers of AT (including other disorders of defective DNA repair), and the realm of therapeutic research for AT.
共济失调毛细血管扩张症(AT)是一种罕见的神经皮肤综合征,由共济失调毛细血管扩张突变(ATM)基因的双等位致病变异引起,因其在幼儿期的特征性小脑性共济失调和学龄期的可变眼皮肤毛细血管扩张而得名。虽然它的名字只暗示神经和皮肤的表现,但这种多系统疾病也有重要的免疫、肿瘤、呼吸和内分泌方面的影响。本文将对ATM基因的功能、AT的神经系统表现、非神经系统并发症、AT的模拟物(包括其他DNA修复缺陷的疾病)以及AT的治疗研究领域进行综述。
{"title":"Ataxia telangiectasia","authors":"John Collyer,&nbsp;Deepa S Rajan","doi":"10.1016/j.spen.2024.101169","DOIUrl":"10.1016/j.spen.2024.101169","url":null,"abstract":"<div><div>Ataxia telangiectasia (AT) is a rare neurocutaneous syndrome that results from biallelic pathogenic variants in the ataxia telangiectasia mutated (<em>ATM</em>) gene, named for its characteristic cerebellar ataxia in the early toddler years and variable oculocutaneous telangiectasias in the school age years. While its name only hints at neurologic and cutaneous manifestations, this multisystemic disorder also has important immunologic, oncologic, respiratory, and endocrinologic implications. This article will review the function of the <em>ATM</em> gene, the neurologic manifestations of AT, non-neurologic complications, mimickers of AT (including other disorders of defective DNA repair), and the realm of therapeutic research for AT.</div></div>","PeriodicalId":49284,"journal":{"name":"Seminars in Pediatric Neurology","volume":"52 ","pages":"Article 101169"},"PeriodicalIF":2.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142757689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Neurofibromatosis type 1 - an update 1型神经纤维瘤病——最新进展
IF 2.4 4区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-12-01 DOI: 10.1016/j.spen.2024.101172
Manikum Moodley, Karla Robles Lopez
Neurofibromatosis type 1 (NF1) is one of the most common genetic conditions. It can be inherited in an autosomal dominant manner, but almost half of cases occur de novo. NF1 is associated with café-au-lait macules, freckles in the inguinal and axillary region, neurofibromas, Lisch nodules of the iris or choroidal abnormalities, optic pathway gliomas, and distinctive bone anomalies. It has complete penetrance but highly variable disease manifestations. Certain features including café-au-lait macules, bony abnormalities, and optic pathway gliomas emerge by early childhood, but others appear later in life. A cure for NF1 has not been found, however emerging treatments have involved modulation of the RAS/MAPK signaling pathway.
1型神经纤维瘤病(NF1)是最常见的遗传病之一。它可以遗传常染色体显性方式,但几乎一半的病例发生从头。NF1与卡萨梅-au-lait斑疹、腹股沟和腋窝区域的雀斑、神经纤维瘤、虹膜或脉络膜异常的Lisch结节、视神经胶质瘤和明显的骨异常有关。它具有完全外显率,但疾病表现变化很大。某些特征,包括卡萨梅-奥-莱斑疹、骨骼异常和视神经胶质瘤,在儿童早期就出现了,但其他特征则在生命后期出现。目前尚未发现治愈NF1的方法,但新兴的治疗方法涉及RAS/MAPK信号通路的调节。
{"title":"Neurofibromatosis type 1 - an update","authors":"Manikum Moodley,&nbsp;Karla Robles Lopez","doi":"10.1016/j.spen.2024.101172","DOIUrl":"10.1016/j.spen.2024.101172","url":null,"abstract":"<div><div>Neurofibromatosis type 1 (NF1) is one of the most common genetic conditions. It can be inherited in an autosomal dominant manner, but almost half of cases occur <em>de novo</em>. NF1 is associated with café-au-lait macules, freckles in the inguinal and axillary region, neurofibromas, Lisch nodules of the iris or choroidal abnormalities, optic pathway gliomas, and distinctive bone anomalies. It has complete penetrance but highly variable disease manifestations. Certain features including café-au-lait macules, bony abnormalities, and optic pathway gliomas emerge by early childhood, but others appear later in life. A cure for NF1 has not been found, however emerging treatments have involved modulation of the RAS/MAPK signaling pathway.</div></div>","PeriodicalId":49284,"journal":{"name":"Seminars in Pediatric Neurology","volume":"52 ","pages":"Article 101172"},"PeriodicalIF":2.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142757763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Seminars in Pediatric Neurology
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1