Is the tumor in children is same as in adults?

Is the tumor in children is same as in adults?It’s actually very different.

All called tumors, but different

Many people think that childhood tumors are adult tumors that are one size smaller. If they are treated, the amount of medicine should be halved.
Really?

On the surface, there are indeed many similarities between childhood tumors and adult tumors.

For example, they can all occur in similar organs: children and adults have leukemia; children and adults have brain tumors; children and adults have kidney cancer, and so on.

For example, they look the same under the microscope: tumors in children and adults, under the microscope, look like a bunch of abnormally growing, out-of-control cells.

For example, their treatment methods are similar: Surgery, radiotherapy, and chemotherapy are the most common treatments for children and adults.

But these are superficial phenomena, and their similarities end here. As long as everyone has a deep understanding, you will find that adult tumors are completely different from childhood tumors!

Whether it is the incidence rate, pathogenesis, treatment options, treatment effects, children and adult tumors are very different.

Childhood tumors and adult tumors are completely different diseases!

Childhood tumors

Gene mutations are not the same

In terms of pathogenesis, the types of gene mutations and immune escape mechanisms of childhood tumors are different from those of adults.

What is the difference between the two gene mutations?

In 2018, two papers were published in the top “Nature” magazine, which analyzed in detail the difference between gene mutations in childhood cancer and adult cancer.

By sequencing more than 2600 samples of more than 20 types, scientists analyzed and summarized the types of mutations in childhood tumors, and compared them with adult samples.

The results showed that compared with adult tumors, the genetic mutations of childhood tumors have their own characteristics, including a relatively low mutation rate, a high proportion of single-gene mutations, and a higher specificity of mutations in different cancers, and so on.

On the whole, only about 40% of the driver mutations in childhood tumors overlap with those in adults, and about 60% are unique to childhood tumors.

For example, the PAX3-FOXO1 fusion gene mutation in rhabdomyosarcoma is not found in other adult tumors.

Even tumors that look similar on the surface have different pathogenesis behind them.

For example, they are all brain gliomas. The common gene mutations in adults are EGFR, IDH1, NF1, etc., while the common mutations in children are H3F3A, ACVR1, etc.

They are all leukemias, and the genetic mutations in adults and children are also very different.

Tumors in children treatment methods are Different

Due to biological characteristics, including different types of gene mutations, treatment methods for childhood tumors are also different.

Due to different mutations, many targeted drugs commonly used by adults, such as EGFR targeted drugs for the treatment of lung cancer, ALK targeted drugs, etc., are not suitable for children. We need to study separately and develop drugs separately.

Even with chemotherapy, a broad-spectrum drug, the choice between children and adults is different.

For example, for glioma, although chemotherapy is a common treatment, the choice of chemotherapy drugs is different. Because the drugs commonly used by adults are not effective for children.

The most commonly used chemotherapeutic drug for adult patients is temozolomide, because it is clinically proven to slow the progression of the disease. It also plays a role in children’s adrenal cortical carcinoma and neuroblastoma brain metastases; but children with glioma patients use this medicine to break, because clinical trials show no benefit!

Children with glioma should choose other chemotherapy drugs, including procarbazine, nitrosourea and vincristine.

Unfortunately, some children are still treated with temozolomide. why?

In many cases, it is because there are no children’s brain tumor specialists in some areas, but adult doctors are used to treat them. They can’t see a few children in their lives and lack experience. If they simply copy the adult treatment plan without consulting the information, it is easy to make mistakes.

This is why it is necessary to repeatedly emphasize the difference between childhood and adult tumors. It is useful not only for the general public, but also for parents and non-specialist doctors.

Tumors in children: The overall treatment effect is different

In addition to the possible differences in the choice of treatment drugs, the overall treatment effects of children and adults are also different.

As mentioned in the previous article, the overall survival rate of childhood tumors can reach more than 80%, which is much higher than that of adults.

If children and adults have similar tumors, the survival rate of children is much better than that of adults.

For example, all cases of acute myeloid leukemia, the overall 5-year survival rate of children is 67%, but what about adults? Only 28%.

For Hodgkin’s lymphoma, the overall 5-year survival rate for children is over 98% and that for adults is 87%.

Children’s tumor treatment is more effective. On the one hand, the characteristics of the tumor determine that the drug resistance is not as serious as that of adults; on the other hand, children are in good physical condition, can withstand stronger radiotherapy and chemotherapy, and have a stronger recovery ability after treatment.

In short, I hope everyone understands that childhood tumors and adult tumors are not the same, they are completely different diseases, and the experience of adults cannot be directly transferred to children.

In order to achieve better curative effects, special research on childhood tumors is imperative. Let’s work hard together!

(source:internet, reference only)

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