Professors Yang Fan, Han Yong, and Wang Hangzhou: When Can Children Resume School After Treatment? Is Lifelong Follow-Up Necessary?  

1. How Long After Treatment for Pediatric Glioma Can Children Resume School?  

Generally speaking, children can return to school 3 to 6 months after completing treatment for pediatric glioma, but the exact timing varies for each child. The ultimate goal of treating malignant tumors is to restore health and allow children to enjoy learning and living like their peers. After initial chemotherapy and radiation therapy, some children may experience side effects such as hair loss, weakened immune systems, or suppression of bone marrow function. Typically, recovery occurs within 3 to 6 months, and if there are no other uncomfortable symptoms, they can resume school and return to normal life.  

However, a small number of children may experience serious adverse reactions due to tumor pressure or the effects of radiation and chemotherapy, such as liver and kidney damage, heart function impairment, vision loss, hearing damage, or restricted mobility. For these children, it is essential to wait until their discomfort alleviates before considering a return to school.  

Once children return to school, they should take precautions to avoid infections, prevent excessive fatigue, maintain a balanced diet, and engage in moderate physical exercise. Additionally, due to differences in age, personality, and psychological maturity, some children may experience psychological issues when reintegrating into school life after long-term hospitalization. It is crucial for family members to communicate with teachers, provide timely psychological support, and help guide children back into their school environment.  

2. What Symptoms in Pediatric Glioma Patients Should Raise Concerns About Tumor Recurrence?  

If a pediatric glioma recurs after treatment, it is essential to analyze the specific situation of the patient. For example, some tumors may have a significant residual cavity after the previous surgical resection, and early recurrences might not present noticeable symptoms until a follow-up examination reveals significant tumor growth. However, in cases of recurrence in specific tumor locations, patients may exhibit symptoms such as headaches, nausea, vomiting, or relevant neurological symptoms like seizures or limb movement disorders.  

Thus, for pediatric glioma patients who have undergone surgery, even after the completion of surgery, radiation, and chemotherapy, close follow-up and regular monitoring are necessary. Generally, some recurrences may not have clinical symptoms, while certain clinical symptoms do not always indicate recurrence and may also stem from treatment-related adverse reactions. Given the complexity of these situations, it is advisable for glioma patients to adhere to their doctors' recommendations for regular follow-up examinations to allow for early detection and diagnosis of recurrences and to initiate timely treatment.  

3. How Often Should Children Be Reexamined After Treatment for Pediatric Glioma? What Should Be Included in These Follow-Ups?  

After completing treatment, children typically undergo follow-up MRI scans of the head and spine with contrast enhancement. Patients who have received radiation therapy should also have their endocrine indicators rechecked. Generally, MRI examinations are conducted every 3 months for the first 1 to 2 years after treatment, then every 6 months during the 3rd to 5th years. Endocrine indicators are usually checked once a year, with increased frequency if abnormalities are detected. After 5 years, annual follow-ups are sufficient.  

Follow-up timing can also be calculated based on the surgery date. Within 2 years post-surgery (or within 1 year after chemotherapy), MRI scans should be done every 3 months, and every 6 months during the 3rd to 5th years. Endocrine indicators typically require annual checks, with increased frequency for any abnormalities. After 5 years, annual follow-ups are sufficient.  

4. Is Lifelong Follow-Up Necessary After Treatment for Pediatric Glioma?  

Yes, lifelong follow-up is necessary after treatment for pediatric glioma. For children with malignant tumors, follow-up is equally important as treatment. Some glioma patients can be cured through comprehensive treatment involving surgery, chemotherapy, and radiation therapy, but they still face risks of recurrence, metastasis, or developing second tumors. Regular follow-ups can help detect signs of tumor recurrence, metastasis, or second tumors early, allowing for timely intervention and improving survival chances.  

Additionally, some children may experience organ function damage, endocrine disorders, pituitary dysfunction, hearing impairment, malnutrition, or growth and developmental limitations as immediate or long-term adverse reactions after comprehensive treatment. Some children may require lifelong medication for replacement therapy. Through lifelong follow-ups, healthcare providers can monitor these adverse reactions and provide timely guidance, rehabilitation training, and interventions to improve the child’s quality of life.  

5. What Other Aspects Should Be Considered After Treatment for Pediatric Glioma Beyond Tumor Control?  

Rehabilitation Therapy: Rehabilitation therapy is crucial for improving the quality of life for children, including physical therapy, occupational therapy, speech and swallowing therapy, cognitive and behavioral therapy, and psychological counseling.  

Endocrine Monitoring: If a child has concurrent endocrine disorders, they need specialized endocrine follow-ups to regularly monitor hormone levels and growth and development.  

Neuropsychological Assessment: Regular neuropsychological assessments should be conducted to monitor cognitive function and intelligence, which may be affected by radiation.  

Psychological Support: Psychological counseling should be integrated throughout the entire treatment process for children with brain gliomas, helping to alleviate fears, anxiety, and depression, while also providing psychological support and education for family members and caregivers.  

Nutrition and Lifestyle: Ensuring that children meet their nutritional needs and encouraging healthy lifestyles, including appropriate physical activity and good dietary habits, is essential.  

Education and Socialization: Encouraging children to participate in social activities and education will help them return to a normal life as soon as possible.  

Family Support: Family support is vital for children's recovery. Emotional support and understanding from parents and other family members can significantly help children cope with the challenges posed by their illness.