A.R. VOLKOVA¹, KH.M. VAKHITOV¹, E.V. KUMIROVA², A.G. MAKHMUTOVA¹

 ¹Kazan State Medical University, Kazan

²Morozov Children’s Clinical Hospital, Moscow

Contact details:

Vakhitov Kh.M. — MD, Professor of the Department of Hospital Pediatrics

Address: 49 Butlerov St., Kazan, Russian Federation, 420012, tel.: +7-917-278-03-78, e-mail: Vhakim@mail.ru

 The article provides up-to-date information on the first clinical symptoms of brain tumors in children and considers the term «pre-diagnostic symptomatic interval» of pediatric medulloblastoma, which is widely used in foreign pediatric and neuro-oncological practice. The authors publish the results of their own retrospective population study revealing the clinical and epidemiological characteristics of the most frequently detected malignant brain tumors in children — medulloblastomas in the pediatric population of the Republic of Tatarstan. The analysis of the pre-diagnostic symptomatic interval of this pathology was carried out through the prism of the LOWorPAY scheme, recommended by neurooncologists as a guide for early detection of tumors for primary care physicians. A probabilistic model of the clinical symptom complex is proposed, which determines the risk of neoplasm of the central nervous system in children. Its use will help increase the oncological alertness of doctors and systematize the tactics of detecting brain and spinal cord tumors in children on an outpatient basis.

Key words: children, medulloblastoma, pre-diagnostic interval, duration.

REFERENCES

1. De Souza R.M. et al. Pediatric medulloblastoma — update on molecular classification driving targeted therapies. Frontiers Research Foundation, 2014.
2. George I., Jallo M. Medulloblastoma: Background, Pathophysiology, Epidemiology, available at: https://emedicine.medscape.com/article/1181219-overview (accessed on: 09.06.2021).
3. Khan M. et al. Medulloblastoma incidence and survival — A Population Based Study. Neuro-Oncol, 2018,  vol. 20 (5),  pp. v350–v351.
4. Alomar S.A. Clinical manifestation of central nervous system tumor. Semin. Diagn. Pathol, 2010,  vol. 27 (2),  pp. 97–104.
5. Armstrong G.T. Long-term survivors of childhood central nervous system malignancies: the experience of the Childhood Cancer Survivor Study. Eur. J. Paediatr. Neurol. EJPN Off. J. Eur. Paediatr. Neurol. Soc, 2010,  vol. 14 (4),  pp. 298–303.
6. Hovestadt V. et al. Medulloblastomics revisited: biological and clinical insights from thousands of patients. Nat. Rev. Cancer, 2020,  vol. 20 (1), pp. 42–56.
7. Coven S.L. et al. Delays in diagnosis for children with newly diagnosed central nervous system tumors. Neuro-Oncol. Pract, 2018,  vol. 5 (4),  pp. 227–233.
8. Erdmann F. et al. Socioeconomic differences in the risk of childhood central nervous system tumors in Denmark: a nationwide register-based case–control study. Cancer Causes Control, 2020,  vol. 31 (10),  pp. 915–929.
9. Maaz A.U.R. et al. Presenting symptoms and time to diagnosis for Pediatric Central Nervous System Tumors in Qatar: a report from Pediatric Neuro-Oncology Service in Qatar. Childs Nerv. Syst, 2021,  vol. 37 (2),  pp. 465–474.
10. Walker D. et al. A new clinical guideline from the Royal College of Pediatrics and Child Health with a national awareness campaign accelerates brain tumor diagnosis in UK children — «head Smart: Be Brain Tumor Aware». Neuro-Oncol, 2016, vol. 18 (3),  pp. 445–454.