Pediatric central nervous system (CNS) tumors, including gliomas, medulloblastomas, and diffuse midline gliomas (previously diffuse intrinsic pontine gliomas), remain a major clinical challenge due to their complex biology, limited treatment effectiveness, and generally poor prognosis. Standard treatments are often aggressive and associated with substantial toxicity, particularly in advanced stages. This review highlights recent developments in radiopharmaceuticals for molecular imaging and targeted radiotherapy. A comprehensive literature analysis was conducted, focusing on radiotracers with clinical relevance in pediatric neuro-oncology, including metabolic, peptide receptor-based, and antibody-based agents. Radiopharmaceuticals such as18F-FLT,64CuCl2, and 1-L-18F-FETrp have improved the ability to monitor tumor biology, proliferation, and treatment response, aiding in diagnosis at an early stage, assessment of tumor behavior, and detection of recurrence or progression. Additionally, peptide receptor-based radiotracers, such as68Ga-DOTATATE and177Lu-DOTATATE, are already used for both diagnostic purposes and targeted radiotherapy, particularly in neuroblastomas and gliomas. Antibody-based radiotracers like131I-omburtamab, targeting B7-H3, are emerging as promising tools for addressing difficult-to-treat tumors such as diffuse midline glioma. Collectively, these advances provide new hope for children afflicted by these devastating malignancies, offering promising solutions for more specific and precise diagnosis and, additionally, for more effective, personalized, and less toxic tumor therapies.
儿童中枢神经系统肿瘤，包括胶质瘤、髓母细胞瘤和弥漫性中线胶质瘤（原称弥漫性内生性桥脑胶质瘤），因其复杂的生物学特性、有限的治疗效果及普遍不良的预后，仍是临床面临的主要挑战。标准治疗方案往往具有侵袭性，尤其在晚期阶段常伴随显著的毒性反应。本综述重点探讨了用于分子影像学与靶向放射治疗的放射性药物最新进展。通过全面的文献分析，聚焦于在儿童神经肿瘤学中具有临床相关性的放射性示踪剂，包括代谢类、肽受体靶向类及抗体类制剂。诸如¹⁸F-FLT、⁶⁴CuCl₂和1-L-¹⁸F-FETrp等放射性药物，显著提升了监测肿瘤生物学特性、增殖状态及治疗反应的能力，有助于早期诊断、评估肿瘤行为以及检测复发或进展。此外，基于肽受体的放射性示踪剂（如⁶⁸Ga-DOTATATE和¹⁷⁷Lu-DOTATATE）已同时应用于诊断和靶向放射治疗，尤其在神经母细胞瘤和胶质瘤中显示出价值。靶向B7-H3的抗体类示踪剂如¹³¹I-omburtamab，正成为治疗弥漫性中线胶质瘤等难治性肿瘤的新兴工具。总体而言，这些进展为罹患此类恶性疾病的儿童带来了新的希望，为实现更精准特异的诊断、以及更有效、个性化且低毒性的肿瘤治疗提供了前景广阔的解决方案。
From Seeing to Healing: The Clinical Potential of Radiotracers in Pediatric Neuro-Oncology
肿瘤(癌症)患者之家