Medical Overview

Brain tumors compose nearly 20% of all childhood cancers and are the most common form of solid malignant tumor that occurs in childhood. The incidence rate is nearly 3.5 cases per 100,000 person-years. Three thousand children are diagnosed with a primary brain tumor every year. Mortality is high, with a 5-year survival rate of 63% following the diagnosis of a primary malignant brain tumor (Central Brain Tumor Registry of the United States 2002). Treatment for childhood brain tumors has not changed significantly over the past 20 years, with most lesions requiring a combination of surgery, radiation, and chemotherapy. Surgery has inherent limitations when certain situations make an excision of the tumor risky or nearly impossible. Radiation therapy is most often used in combination with surgery, but the side effects, particularly in young children, can lead to severe cognitive and behavioral dysfunction. Corticosteroids, including dexametha-sone, decrease the edema associated with brain tumors and improve the symptoms that are caused by brain swelling. Unfortunately, these medications often result in side effects that include mood lability and psychosis. The drugs also decrease blood-brain barrier permeability and increase the toxicity and drug interactions from chemotherapeutic agents.

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