Mohamed S. Zaghloul

[69] Balducci S, Iacobellis G, Parisi L, Di Biase N, Calandriello E, Leonetti F, Fallucca F (2006) Exercise training can modify the natural history of diabetic peripheral neuropathy J

[70] Carter GT, Kikuchi N, Abresch RT, Walsh SA, Horasek S, Fowler WM (1994) Effects of exhaustive concentric and eccentric exercise on murine skeletal muscle. Arch Phys Med

[71] Carter GT, Abresch RT, Fowler WM (2002) Adaptations to exercise training and contraction-induced muscle injury in animal models of neuromuscular disease. Am J

Diabetes Complicat 20: 216–23.

Phys Med Rehabil 81(suppl): S151–S161.

Rehabil 75: 555–59.

446 Neurooncology - Newer Developments

Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/63111

#### **Abstract**

Pediatric cancer is becoming increasingly important in low-/middle-income countries (LMICs), due to the improvement in controlling communicable diseases, decrease infant, and early childhood mortalities associated with infection and malnutrition.

Worldwide, although much improvement was encountered in many pediatric tumors particularly acute leukemia that represents the commonest type of cancer in children, this was not so obvious in CNS tumors, the second most common tumor type. Slow advances have been achieved to improve treatment end results in pediatric neuro-oncology. This was largely related to disease under diagnosis, incorrect clinical assessment, improper staging, and lack of the availability of appropriate radiologic, neurosurgical, and radiotherapeutic services in LMICs. Moreover, the need for multidisciplinary team working together to embalmment unified approved management guidelines, highly specific care level within a widely accepted quality control measures are of utmost importance to raise the treatment outcome levels to that of high-income countries (HICs).

Much effort is needed in LMICs to improve the management of pediatric CNS tumors, decrease the gap, and reach good results already attained by the dedicated centers in HICs. There are many international organizations and societies that can and are willing to help in this matter.

In this chapter, an illustration of the obstacles faced by LMIC neuro-oncologists will be discussed. The different ways and procedures are recommended to improve the general situation to attain good results similar to that in HICs.

**Keywords:** neuro-oncology, children, low-/middle-income countries, LMIC, CNS tu‐ mors, brain, late sequelae

© 2016 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.
