{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T19:33:36Z","timestamp":1780515216704,"version":"3.54.1"},"reference-count":48,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,7,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Brain tumors in infants and young children may constitute a challenge to achieve a gross-total resection (GTR) due to their large size, high vascularity, and patient\u2019s low vascular reserve. Preoperative (neoadjuvant) chemotherapy has been reported to increase rates of GTR, reduce complications, and improve long-term tumor-free survival outcomes by decreasing tumor size and vascularity. This study evaluates the role of preoperative chemotherapy in pediatric patients with brain tumors through a systematic review and a single tertiary center experience.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>A systematic review was conducted using three databases (i.e., MEDLINE, Embase, and Web of Science) to identify reported cases of pediatric brain tumor treated with preoperative chemotherapy. Furthermore, the records of 6 pediatric brain tumor patients treated with preoperative chemotherapy at Texas Children\u2019s Hospital between 2018 and 2023 were reviewed. Descriptive characteristics and clinical outcomes were assessed in compliance with the local ethics committee protocol.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Twenty-one studies with 124 patients were included in the systematic review. The mean age at presentation was 32 months (range 0.17\u2013144 months), with a male predominance (n = 73, 58.9%). The mean age of the current single-center cohort was 50.3 months (range 2\u2013180 months), with a mean follow-up of 45 months (range 4\u201345 months). Within the systematic review, 10 different tumor pathologies were identified, the most common being medulloblastoma (n = 61), followed by choroid plexus carcinoma (n = 26). Overall, 82.3% (102\/124) of the patients showed any radiographic tumor reduction after chemotherapy in the literature review versus 50% (3\/6) in the current case series. GTR after preoperative chemotherapy was achieved in 78.2% (97\/124) of the patients, similar to the current patient series experience in which GTR was achieved in 80% (4\/5). No complications from preoperative chemotherapy that impacted the surgery or the immediate postoperative course were identified.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Preoperative chemotherapy is a safe and effective strategy to increase maximum and safe resection rates in children and infants with pediatric brain tumors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2025.1.peds24512","type":"journal-article","created":{"date-parts":[[2025,4,25]],"date-time":"2025-04-25T22:48:22Z","timestamp":1745621302000},"page":"75-88","source":"Crossref","is-referenced-by-count":1,"title":["The role of preoperative chemotherapy in pediatric neuro-oncology: a single-center experience and a systematic review of the literature"],"prefix":"10.3171","volume":"36","author":[{"given":"Roboan","family":"Guillen Arguello","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana;"},{"name":"Department of Surgery, Division of Neurosurgery, Texas Children\u2019s Hospital, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle Masayo","family":"Kameda-Smith","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Division of Pediatric Neurosurgery, Baylor College of Medicine, Houston, Texas;"},{"name":"Department of Pediatrics, Texas Children\u2019s Hematology and Cancer Centers and Hematology-Oncology, Baylor College of Medicine, Houston, Texas; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nisha","family":"Gadgil","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Division of Pediatric Neurosurgery, Baylor College of Medicine, Houston, Texas;"},{"name":"Department of Surgery, Division of Neurosurgery, Texas Children\u2019s Hospital, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehmet Fatih","family":"Okcu","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Texas Children\u2019s Hematology and Cancer Centers and Hematology-Oncology, Baylor College of Medicine, Houston, Texas; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Murali","family":"Chintagumpala","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Texas Children\u2019s Hematology and Cancer Centers and Hematology-Oncology, Baylor College of Medicine, Houston, Texas; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillermo","family":"Aldave","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Division of Pediatric Neurosurgery, Baylor College of Medicine, Houston, Texas;"},{"name":"Department of Surgery, Division of Neurosurgery, Texas Children\u2019s Hospital, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"3","key":"b1","series-title":"Jude experience. 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J Neurosurg Pediatr. 2011;8(2):149\u2013153."},{"issue":"4 suppl","key":"b3","series-title":"J Neurosurg","first-page":"312","article-title":"Preoperative chemotherapy in children with high-risk medulloblastomas: a feasibility study","volume":"103","author":"Grill J","year":"2005","unstructured":"Grill J, Lellouch-Tubiana A, Elouahdani S,  Preoperative chemotherapy in children with high-risk medulloblastomas: a feasibility study. J Neurosurg. 2005;103(4 suppl):312\u2013318."},{"issue":"2","key":"b4","series-title":"J Neurosurg Pediatr","first-page":"126","article-title":"Neoadjuvant chemotherapy reduces blood loss during the resection of pediatric choroid plexus carcinomas","volume":"16","author":"Schneider C","year":"2015","unstructured":"Schneider C, Kamaly-Asl I, Ramaswamy V,  Neoadjuvant chemotherapy reduces blood loss during the resection of pediatric choroid plexus carcinomas. 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Pediatr Neurosurg. 1991-1992;17(5):225-233."},{"issue":"6","key":"b7","series-title":"Pediatr Neurosurg","first-page":"296","article-title":"Neoadjuvant chemotherapy for hypervascular malignant brain tumors of childhood","volume":"27","author":"Razzaq AA","year":"1997","unstructured":"Razzaq AA, Cohen AR. Neoadjuvant chemotherapy for hypervascular malignant brain tumors of childhood. Pediatr Neurosurg. 1997;27(6):296\u2013303."},{"issue":"2","key":"b8","series-title":"Br J Neurosurg","first-page":"207","article-title":"The use of neo adjuvant single-agent vinblastine for tumour shrinkage in a highly vascular paediatric low-grade glioma","volume":"34","author":"Stagno V","year":"2020","unstructured":"Stagno V, Mallucci C, Avula S, Pizer B. The use of neo adjuvant single-agent vinblastine for tumour shrinkage in a highly vascular paediatric low-grade glioma. 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Childs Nerv Syst. 2023;39(9):2349\u20132352."},{"issue":"6","key":"b13","series-title":"J Neurosurg Pediatr","first-page":"615","article-title":"Use of ifosfamide, carboplatin, and etoposide chemotherapy in choroid plexus carcinoma","volume":"5","author":"Lafay-Cousin L","year":"2010","unstructured":"Lafay-Cousin L, Mabbott DJ, Halliday W,  Use of ifosfamide, carboplatin, and etoposide chemotherapy in choroid plexus carcinoma. J Neurosurg Pediatr. 2010;5(6):615\u2013621."},{"issue":"4","key":"b14","series-title":"Med Pediatr Oncol","first-page":"274","article-title":"The treatment of malignant scala posterior tumors in children: II. Preliminary result of the pre- and postoperative adjuvant chemotherapy of scala posterior tumors","volume":"21","author":"Schuler D","year":"1993","unstructured":"Schuler D, Soml\u00f3 P, Ko\u00f3s R, K\u00e1lm\u00e1nchey R, Paraicz E. The treatment of malignant scala posterior tumors in children: II. 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Successful use of dose dense neoadjuvant chemotherapy and sodium valproate with minimal toxicity in an infant with medulloblastoma in extremely poor general condition. World Neurosurg. 2016;93:485.e1\u2013485.e5."},{"issue":"3","key":"b1","series-title":"Jude experience. J Neurosurg Pediatr","first-page":"251","article-title":"Resection of infantile brain tumors after neoadjuvant chemotherapy: the St","volume":"8","author":"Van Poppel M","year":"2011","unstructured":"Van Poppel M, Klimo P Jr, Dewire M,  Resection of infantile brain tumors after neoadjuvant chemotherapy: the St. Jude experience. J Neurosurg Pediatr. 2011;8(3):251\u2013256."},{"issue":"2","key":"b2","series-title":"J Neurosurg Pediatr","first-page":"149","article-title":"Preoperative vincristine for an inoperable choroid plexus papilloma: a case discussion and review of the literature","volume":"8","author":"Addo NK","year":"2011","unstructured":"Addo NK, Kamaly-Asl ID, Josan VA, Kelsey AM, Estlin EJ. 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Neuro Oncol. 2020;22(11):1686\u20131695."},{"issue":"5","key":"b10","series-title":"J Neurosurg Pediatr","first-page":"488","article-title":"Neoadjuvant chemotherapy for brain tumors in infants and young children","volume":"15","author":"Iwama J","year":"2015","unstructured":"Iwama J, Ogiwara H, Kiyotani C,  Neoadjuvant chemotherapy for brain tumors in infants and young children. J Neurosurg Pediatr. 2015;15(5):488\u2013492."},{"issue":"3","key":"b11","series-title":"JBI Evid Synth","first-page":"467","article-title":"Assessing the risk of bias of quantitative analytical studies: introducing the vision for critical appraisal within JBI systematic reviews","volume":"21","author":"Munn Z","year":"2023","unstructured":"Munn Z, Stone JC, Aromataris E,  Assessing the risk of bias of quantitative analytical studies: introducing the vision for critical appraisal within JBI systematic reviews. 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J Neurosurg Pediatr. 2017;19(5):546\u2013552."},{"issue":"2","key":"b18","series-title":"J Neurooncol","first-page":"167","article-title":"Volumetric reduction of a choroid plexus carcinoma using preoperative chemotherapy","volume":"43","author":"Souweidane MM","year":"1999","unstructured":"Souweidane MM, Johnson JHJ Jr, Lis E. Volumetric reduction of a choroid plexus carcinoma using preoperative chemotherapy. J Neurooncol. 1999;43(2):167\u2013171."},{"issue":"6","key":"b19","series-title":"Pediatr Hematol Oncol","first-page":"538","article-title":"Chemotherapy increases amenability of surgical resection in congenital glioblastoma","volume":"29","author":"Kotecha RS","year":"2012","unstructured":"Kotecha RS, Burley K, Junckerstorff RC,  Chemotherapy increases amenability of surgical resection in congenital glioblastoma. 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