**Author details**

Siddharth K. Joshi1 and Richard Zuniga2\*

\*Address all correspondence to: rickzunigaperu@hotmail.com

1 Department of Medicine, New York Methodist Hospital, Brooklyn, New York, USA

2 Department of Medicine-Division of Hematology-Oncology, New York Methodist Hospital, Brooklyn, New York, USA

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**Chapter 2**

**Paediatric Brainstem Cancers — Where We Have Been;**

In North America and Europe, cancer involving the central nervous system (CNS) ranks second as the most common malignancy seen in infancy through adolescence, second only to leukaemia [1-7]. Consistent with this are figures on cancer-related mortality. In the year 2004, for example, there were 566 confirmed cases of leukemia-related death among children in the United States, followed by 555 CNS cancer-related deaths; these numbers accounted for 25.5% and 25.0% of the total number of cancer deaths in individuals less than 20 years old, respec‐

In general, survival from cancer has improved dramatically over the past forty years, pre‐ sumably due to a combination of improved treatments and earlier detection. This is especially true in the paediatric population, among whom the overall long-term survival rate across all cancers has risen from under 50% to roughly 70% [4;8;9]. Even with brain cancer, the prognosis in children has improved, such that long-term survival is now achieved in more than half of patients [10]. This being said, the neoplasm originates in the brainstem in roughly 10-20% of children with CNS cancer [7;11-13], accounting for 150 to 300 new cases per year in the U.S. [11;13] and thus rendering it more common in children and adolescents than in adults [14;15]. And in this subset of children, the prognosis generally is considered extremely bleak, akin to

Despite a continued poor prognosis, much has changed over the past several decades — like how paediatric brainstem tumours are diagnosed and classified, if and when surgery is considered, approaches to surgery, the use of adjunct therapies like radiation and chemother‐ apy, and the evolution of several new therapeutic options. Once lumped together as a single

> © 2014 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

**Where We Are; Where We Are Going**

Adrianna Ranger, Navjot Chaudhary and

Additional information is available at the end of the chapter

that of glioblastoma multiforme [1;4;14;16-19].

Jonathan Lau

**1. Introduction**

tively [4].

http://dx.doi.org/10.5772/58297
