Effect of multidisciplinary group based treatment for pediatric central nervous system tumor at The University of Hong Kong - Shenzhen Hospital

Abstract

Objective: Although, in Shen Zhen, a single disciplinary group such as neurosurgeons agree upon the management mainstay includes a multimodal approach of surgery, radiation therapy, and chemotherapy, there is not broad involvement of the doctors from different fields. We assessed the effectiveness of a multidisciplinary group based treatment aiming to improve the survival rate of childhood central nervous system(CNS) malignancy. Method: This is a five-year retrospective review of the effect of our multidisciplinary treatment for pediatric CNS tumor at The University Of Hong Kong– Shen Zhen Hospital from 2013-2018. Eligible participants were children aged 0-14 years who attended the hospital and were given a multimodal therapy following a primary diagnosis of CNS tumors. The interventions include surgery, chemotherapy and radiation therapy. A CNS tumor warrants a referral to a neurosurgeon for biopsy, and gross total resection where possible. Radiation therapy and chemotherapy are used as adjunct measures based on the histology of the tumor. The survival rate of children is evaluated. Result: There were 45 cases of childhood CNS tumors, includes 49% Medulloblastomas, 18% Embryonal tumors, 8%Ependymomas, and 20%Gliomas had been evaluated. Medulloblastomas shows the best outcome while Embryonal tumors including 4 atypical teratoid/rhabdoid tumors(ATRT), 3 embryonal tumor with multilayered rosettes (ETMR) and 1 central nervous system (CNS) embryonal tumor not otherwise specified (NOS), previously called CNS primitive neuroectodermal tumor (PNET) shows the worst prognosis Conclusion: Multidisciplinary Group Based Treatment improves the childhood primary malignant central nervous system (CNS) tumors survival rate especially for Medulloblastoma.