Adjuvant Therapy for Cervicomedullary Tumors in Children

As the majority of these tumors are low-grade or benign processes, surgery is typically the initial treatment modality with adjuvant therapy reserved for recurrent disease.

Radiation Therapy

• Used for inoperable disease: Adjuvant radiotherapy should be reserved for instances of recurrent disease not amenable to surgical re-resection.  Treatment primarily consists of conventional fractionated conformal beam radiotherapy with 54 Gy given in daily fractions over 6 weeks (54-56). The use of stereotactic radiation therapy and stereotactic radiosurgery has also been examined in small cohorts (57, 58).

Chemotherapy

• Use not defined for cervicomedullary tumors: Although a number of trials have examined the efficacy of adjuvant chemotherapy in the treatment of diffuse intrinsic pontine gliomas, no role has been defined for its use in the treatment of cervicomedullary tumors (8,49–53).