Adult Brain Tumors Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Management of Specific Tumor Types and Locations
Brain Stem GliomasStandard treatment options:Radiation therapy.Brain stem gliomas have relatively poor prognoses that correlate with histology (when biopsies are performed), location, and extent of tumor. The overall median survival time of patients in studies has been 44 to 74 weeks.Current Clinical TrialsCheck for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with adult brain stem glioma. The list of clinical trials can be further narrowed by location, drug, intervention, and other criteria.General information about clinical trials is also available from the NCI Web site.Pineal Astrocytic TumorsStandard treatment options:Surgery plus radiation therapy for patients with pilocytic or diffuse astrocytoma.Surgery plus radiation therapy and chemotherapy for patients with higher grade tumors.Depending on the degree of anaplasia, pineal astrocytomas vary in prognoses. Higher grades have worse prognoses. Pilocytic
Adult Brain Tumors Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Get More Information From NCI
Call 1-800-4-CANCERFor more information, U.S. residents may call the National Cancer Institute's (NCI's) Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237) Monday through Friday from 8:00 a.m. to 8:00 p.m., Eastern Time. A trained Cancer Information Specialist is available to answer your questions.Chat online The NCI's LiveHelp® online chat service provides Internet users with the ability to chat online with an Information Specialist. The service is available from 8:00 a.m. to 11:00 p.m. Eastern time, Monday through Friday. Information Specialists can help Internet users find information on NCI Web sites and answer questions about cancer. Write to usFor more information from the NCI, please write to this address:NCI Public Inquiries Office9609 Medical Center Dr. Room 2E532 MSC 9760Bethesda, MD 20892-9760Search the NCI Web siteThe NCI Web site provides online access to information on cancer, clinical trials, and other Web sites and organizations that offer support
Brain Tumors in Adults
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Childhood Brain and Spinal Cord Tumors Treatment Overview (PDQ®): Treatment - Health Professional Information [NCI] - Changes to This Summary (05 / 29 / 2013)
The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.Editorial changes were made to this summary.This summary is written and maintained by the PDQ Pediatric Treatment Editorial Board, which is editorially independent of NCI. The summary reflects an independent review of the literature and does not represent a policy statement of NCI or NIH. More information about summary policies and the role of the PDQ Editorial Boards in maintaining the PDQ summaries can be found on the About This PDQ Summary and PDQ NCI's Comprehensive Cancer Database pages.
Childhood Brain Stem Glioma Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Stage Information
There is no generally applied staging system for childhood brain stem gliomas. It is uncommon for these tumors to have spread outside the brain stem itself at the time of initial diagnosis. Spread of malignant brain stem tumors is usually contiguous; metastasis via the subarachnoid space has been reported in up to 30% of cases diagnosed antemortem. Such dissemination may occur prior to local relapse but usually occurs simultaneously with or after local disease relapse.The less common tumors of the midbrain, especially in the tectal plate region, have been viewed separately from those of the brain stem because they are more likely to be low grade and have a greater likelihood of long-term survival (approximately 80% 5-year progression-free survival vs. <10% for tumors of the pons).[1,4,5,6,7,8] Similarly, dorsally exophytic and cervicomedullary tumors are generally low grade and have a relatively favorable prognosis. Children younger than 3 years may have a more favorable
Childhood Ependymoma Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Stage Information
Although there is no formal staging system, ependymomas can be divided into supratentorial, infratentorial, and spinal tumors. In children, approximately 30% of childhood ependymomas arise in supratentorial regions of the brain and 70% in the posterior fossa.[1,2,3] They usually originate in the ependymal linings of ventricles or central canal or ventriculus terminalis of the spinal cord, and have access to the cerebral spinal fluid (CSF). Therefore, these tumors may spread throughout the neuraxis, although dissemination is noted in less than 10% of patients with Grade II and Grade III ependymomas. Myxopapillary ependymomas are more likely to disseminate to the nervous system early in the course of illness. Every patient with ependymoma should be evaluated with diagnostic imaging of the spinal cord and whole brain. This is ideally done prior to surgery to avoid confusion with postoperative blood. The most sensitive method available for evaluating spinal cord subarachnoid metastasis
Childhood Astrocytomas Treatment (PDQ®): Treatment - Health Professional Information [NCI] - 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
Pituitary Tumors Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Recurrent Pituitary Tumors Treatment
Standard Treatment Options for Recurrent Pituitary TumorsStandard treatment options for recurrent pituitary tumors include the following:Radiation therapy for postsurgical recurrence, which offers a high likelihood of local control.[1,2]Reirradiation, which provides long-term local control and control of visual symptoms.The question and selection of further treatment for patients who relapse is dependent on many factors, including the specific type of pituitary tumor, prior treatment, visual and hormonal complications, and individual patient considerations. Treatment Options Under Clinical Evaluation for Recurrent Pituitary TumorsTreatment options under clinical evaluation for recurrent pituitary tumors include the following:Stereotactic radiation surgery.[4,5,6]Current Clinical TrialsCheck for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with recurrent pituitary tumor. The list of clinical trials can be further narrowed by
Childhood Ependymoma Treatment (PDQ®): Treatment - Patient Information [NCI] - Treatment Options for Childhood Ependymoma
A link to a list of current clinical trials is included for each treatment section. For some types or stages of cancer, there may not be any trials listed. Check with your child's doctor for clinical trials that are not listed here but may be right for your child.Newly Diagnosed Childhood EpendymomaA child with a newly diagnosed ependymoma has not had treatment for the tumor. The child may have had treatment to relieve symptoms caused by the tumor.Treatment for newly diagnosed childhood ependymoma is usually surgery to remove the tumor. More treatment may be given after surgery. Treatment given after surgery depends on the following:Age of the child.Amount of tumor that was removed.Whether cancer cells have spread to other parts of the brain or spinal cord.Treatment for children aged 3 and olderIf the tumor is completely removed by surgery and cancer cells have not spread within the brain and spinal cord, treatment may include the following:Radiation therapy to the tumor bed (the area