Supplementary Material for: Cervicomedullary gliomas in pediatric age: a review of the literature and tertiary care center experience

Introduction. CMG are usually low-grade tumors often found in pediatric age. Histological findings, treatments and classification have been much the same for 40 years, although histological and molecular classifications have largely been developed for other pediatric CNS tumors. The management and treatment of pediatric CMG is still conducted by many authors according to their anatomical location and characteristics, independently from histology.
Methods. We conducted a literature review in PubMed (Medline) to identify relevant contributions about pediatric CMG published until December 31st, 2021. We also analyzed a series of 10 patients with CMG treated from 2006 to 2021 at IRCCS Istituto Nazionale dei Tumori. The aim of the present review is to see whether and how the diagnosis, treatment and classification of cervicomedullary gliomas (CMG) in children have developed over time, especially in the context of molecular advancements, and to analyze our single center experience in the last 15 years.
Results. Thirty articles have been included in the review. Articles have been divided in two historical periods (1981-2000 and 2001-2021) and data from different series were analyzed to see how much the management and treatment of pediatric CMG have changed during years. Analysis of our series of 10 patients affected by CMG was also performed to compare it with the literature.
Discussion. Management and classification of CMG in children has not dramatically changed during years. However, new insight from molecular diagnostics and target therapies and development of radiological, neurophysiological and radiotherapy techniques have updated treatment modalities in the last 20 years. Treatment modalities and their innovations have been reviewed and discussed. Further studies are needed to standardize and customize treatment protocols for these tumors.

引言。神经管母细胞瘤（CMG）通常为低级别肿瘤，常见于儿童期。自40年前以来，其组织学特征、治疗方案及分类方式基本保持不变，尽管组织学和分子学分类在其他儿童中枢神经系统肿瘤方面已得到广泛发展。目前，许多作者在管理儿童CMG时，仍根据其解剖位置和特征进行独立判断，而与组织学无关。

方法。我们通过PubMed（Medline）进行文献综述，以识别截至2021年12月31日发表的有关儿童CMG的相关贡献。我们还分析了2006年至2021年在IRCCS Istituto Nazionale dei Tumori治疗的10例CMG患者病例。本次综述的目的是探讨儿童颈髓胶质瘤（CMG）的诊断、治疗和分类在时间上的演变情况，尤其是在分子学进步的背景下，并分析过去15年我们单一中心的经验。

结果。本次综述共纳入30篇文章。文章被分为两个历史时期（1981-2000和2001-2021），并分析了不同系列的数据，以观察儿童CMG的管理和治疗在多年间发生了多大变化。我们还对10例CMG患者的病例进行了分析，以将其与文献进行比较。

讨论。儿童CMG的管理和分类在多年间并未发生显著变化。然而，分子诊断和靶向治疗的新见解，以及放射学、神经生理学和放射治疗技术的进步，在过去20年中更新了治疗手段。治疗手段及其创新得到了回顾和讨论。为进一步标准化和定制化这些肿瘤的治疗方案，需要进一步的研究。