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Treatment of Childhood High-Grade Astrocytomas
To determine and implement optimum management, treatment is often guided by a multidisciplinary team of cancer specialists who have experience treating childhood brain tumors. The therapy for both children and adults with supratentorial high-grade astrocytoma includes surgery, radiation therapy, and chemotherapy. Outcome in high-grade gliomas occurring in childhood may be more favorable than that in adults, but it is not clear if this difference is caused by biologic variations in tumor characteristics, therapies used, tumor resectability, or other factors that are presently not understood. The ability to obtain a complete resection is associated with a better prognosis. Radiation therapy is administered to a field that widely encompasses the entire tumor. The radiation therapy dose to the tumor bed is usually at least 54 Gy. Despite such therapy, overall survival rates remain poor. Similarly poor survival is seen in children with spinal cord primaries and children with
General Information About Childhood Brain Stem Glioma
Childhood brain stem glioma is a disease in which benign (noncancer) or malignant (cancer) cells form in the tissues of the brain stem. The brain stem is the part of the brain connected to the spinal cord. It is located in the lowest part of the brain,just above the back of the neck. The brain stem is the part of the brain that controls breathing,heart rate,and nerves and muscles used in ...
This information is produced and provided by the National Cancer Institute (NCI). The information in this topic may have changed since it was written. For the most current information, contact the National Cancer Institute via the Internet web site at http://cancer.gov or call 1-800-4-CANCER.Childhood Brain Stem Glioma Treatment
PDQ IS A COMPREHENSIVE CANCER DATABASE AVAILABLE ON NCI'S WEB SITE. PDQ is the National Cancer Institute's (NCI's) comprehensive cancer information database. Most of the information contained in PDQ is available online at NCI's Web site. PDQ is provided as a service of the NCI. The NCI is part of the National Institutes of Health,the federal government's focal point for biomedical research. .
Classification of Central Nervous System Tumors
The classification of childhood central nervous system (CNS) tumors is based on histology and location. Tumors are classically categorized as infratentorial, supratentorial, parasellar, or spinal. Immunohistochemical analysis, cytogenetic and molecular genetic findings, and measures of mitotic activity are increasingly used in tumor diagnosis and classification, and will likely alter classification and nomenclature in the future.Primary CNS spinal cord tumors comprise approximately 1% to 2% of all childhood CNS tumors. The classification of spinal cord tumors is based on histopathologic characteristics of the tumor and does not differ from that of primary brain tumors.[2,3,4]Infratentorial (posterior fossa) tumors include the following:Cerebellar astrocytomas (most commonly pilocytic, but also fibrillary and less frequently, high-grade).Medulloblastomas (classic, desmoplastic/nodular, extensive nodularity, anaplastic, or large cell) and variants.Ependymomas (cellular, papillary,
Recurrent Childhood Brain Stem Glioma
Recurrent childhood brain stem glioma is a tumor that has recurred (come back) after it has been treated. If childhood brain stem glioma recurs,it may do so many years after initial treatment. The tumor may come back in the brain or in other parts of the central nervous system. ...
General Information About Pituitary Tumors
Pituitary tumors represent from 10% to 25% of all intracranial neoplasms. Depending on the study cited, pituitary tumors can be classified into three groups according to their biological behavior:[1,2]Benign adenoma.Invasive adenoma.Carcinoma. Adenomas comprise the largest portion of pituitary neoplasms with an overall estimated prevalence of approximately 17%. Only a minority of adenomas are symptomatic. In addition, pituitary adenomas may be distinguished anatomically as intrapituitary, intrasellar, diffuse, and invasive. Invasive adenomas, which account for approximately 35% of all pituitary neoplasms, may invade the dura mater, cranial bone, or sphenoid sinus. Carcinomas account for 0.1% to 0.2% of all pituitary tumors.[6,7]Clinical PresentationThe most characteristic-presenting features of pituitary adenomas include inappropriate pituitary hormone secretion and visual field deficits.Rare signs and symptoms of pituitary disease include:Cranial nerve palsies.Temporal
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Prolactin-Producing Pituitary Tumors Treatment
Standard Treatment Options for Prolactin (PRL)-Producing Pituitary TumorsStandard treatment options for PRL-producing pituitary tumors include the following:Dopamine agonists, such as cabergoline and bromocriptine.[1,2,3,4,5] Surgery (second-line).[1,2]Radiation therapy (occasionally).[1,2]When the pituitary tumor secretes PRL, treatment will depend on tumor size and the symptoms that result from excessive hormone production. Patients with PRL-secreting tumors are treated with surgery and radiation therapy.Most microprolactinomas and macroprolactinomas respond well to medical therapy with ergot-derived dopamine agonists, including bromocriptine and cabergoline. For many patients, cabergoline has a more satisfactory side effect profile than bromocriptine. Cabergoline therapy may be successful in treating patients whose prolactinomas are resistant to bromocriptine or who cannot tolerate bromocriptine, and this treatment has a success rate of more than 90% in patients with newly