MD-OncoMD-OncoMD-Onco2782-32022782-6171Publishing House ABV Press17510.17650/2782-3202-2025-5-1-47-58RARE AND COMPLEX CLINICAL SITUATIONS: DIAGNOSIS AND SELECTION OF TREATMENT TACTICSРЕДКИЕ И СЛОЖНЫЕ КЛИНИЧЕСКИЕ СИТУАЦИИ: ДИАГНОСТИКА И ВЫБОР ТАКТИКИ ЛЕЧЕНИЯDiagnosis and treatment of pediatric brain tumorsДиагностика и лечение опухолей головного мозга у детейhttps://orcid.org/0009-0000-3571-4909ShebanovaE. O.ШебановаЕ. О.
Russian Federation

Ekaterina Olegovna Shebanova 

Bld. 2, 8 Trubetskaya St., Moscow 119991

Екатерина Олеговна Шебанова 

119991 Москва, ул. Трубецкая, 8, стр. 2 

katrina.grebennikova@mail.ruhttps://orcid.org/0009-0009-9533-1147KurmanovaA. O.КурмановаА. О.
Russian Federation

Bld. 2, 8 Trubetskaya St., Moscow 119991

119991 Москва, ул. Трубецкая, 8, стр. 2 

https://orcid.org/0000-0001-5841-7480SevyanN. V.СевянН. В.
Russian Federation

Bld. 2, 8 Trubetskaya St., Moscow 119991

119991 Москва, ул. Трубецкая, 8, стр. 2 

https://orcid.org/0000-0001-8880-1758ProzorenkoE. V.ПрозоренкоЕ. В.
Russian Federation

Bld. 2, 8 Trubetskaya St., Moscow 119991

119991 Москва, ул. Трубецкая, 8, стр. 2 

https://orcid.org/0000-0003-0040-3136KirsanovV. Yu.КирсановВ. Ю.
Russian Federation

Bld. 2, 8 Trubetskaya St., Moscow 119991

119991 Москва, ул. Трубецкая, 8, стр. 2 

Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет)060320255147580503202505032025Copyright ©; 2025, ABV-PressCopyright ©; 2025, АБВ-пресс2025ABV-PressАБВ-прессhttps://mdonco.abvpress.ru/jour/about/editorialPolicieshttps://mdonco.abvpress.ru/jour/article/view/175

Brain tumors are the most common solid tumors in children and are associated with high mortality. The most common childhood brain tumors are grouped as low­grade gliomas, high grade gliomas, ependymomas, and embryonal tumors, according to the World Health Organization (WHO). Advances in molecular genetics have led to a shift from pure histopathological diagnosis to integrated diagnosis. For the first time, these new criteria were included in the WHO classification published in 2016 and has been further updated in the 2021 edition. Integrated diagnosis is based on molecular genomic similarities of the tumor subclasses, and it can better explain the differences in clinical courses of previously histopathologically identical entities. Important advances have also been made in pediatric neuro­oncology. A growing understanding of the molecular­genetic background of tumorigenesis has improved the diagnostic accuracy. Re­stratification of treatment protocols and the development of targeted therapies will significantly affect overall survival and quality of life. For some pediatric tumors, these advances have significantly improved therapeutic management and prognosis in certain tumor subgroups. Some therapeutic approaches also have serious long­term consequences. Therefore, optimized treatments are greatly needed.

Опухоли головного мозга являются наиболее часто встречающимися солидными опухолями у детей и связаны с высокой смертностью. По данным Всемирной организации здравоохранения (ВОЗ), наиболее распространенные детские опухоли головного мозга подразделяются на глиомы низкой и высокой степени злокачественности, эпендимомы и эмбриональные опухоли. Достижения в области молекулярной генетики обусловили переход от гистологической диагностики к комплексной диагностике с исследованием молекулярно­генетического статуса опухоли. Впервые эти новые критерии были включены в классификацию ВОЗ, опубликованную в 2016 г., и дополнительно обновлены в издании 2021 г. Комплексная диагностика основана на молекулярно­генетическом сходстве подклассов опухолей и может лучше объяснить различия в клиническом течении гистологически идентичных образований. Значимые достижения есть в детской нейроонкологии. Растущее понимание молекулярно­генетического фона опухолеобразования повысило точность диагностики. Повторная стратификация протоколов лечения и разработка таргетной терапии должны оказать существенное влияние на общую выживаемость и качество жизни. При определенных подгруппах опухолей у детей эти достижения значительно улучшили терапевтический эффект и прогноз для пациентов. Некоторые терапевтические подходы также имеют серьезные долгосрочные последствия, поэтому оптимизированные методы лечения крайне необходимы.

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