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.