Pediatric high-grade gliomas

Pediatric high-grade gliomas comprise different tumor entities of glial origin that are characterized by their malignant histopathologic phenotype or poor clinical course. Glioblastoma multiforme, anaplastic astrocytoma, and pontine glioma represent the most frequent pediatric high-grade gliomas. Current treatment recommendations include surgery, radiotherapy, and chemotherapy, with the exception of pontine gliomas, which are treated solely by radiotherapy and chemotherapy. Complete tumor resection still has the highest prognostic impact. Although overall survival is still poor for most patients, infants and very young children with high-grade gliomas show good overall survival with conventional chemotherapy and surgery. For these patients, a separate chemotherapy protocol is currently being developed in several European countries. For older patients, new multimodal treatment protocols containing innovative tumor-specific as well as conventional treatment strategies must be established.