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
Treatment of Newly Diagnosed and Recurrent Childhood Brain Tumors
The brain is made of different kinds of cells. Childhood brain tumors are grouped and treated based on the type of cell the cancer formed in and where the tumor began growing in the CNS. Some types of tumors are divided into subtypes based on how the tumor looks under a microscope. See Table 1 for a list of tumor types and staging and treatment information for newly diagnosed and recurrent childhood brain tumors.Table 1. The Staging and Treatment of Newly Diagnosed or Recurrent Tumors According to Tumor Type or SubtypeTumor TypeTumor SubtypeStaging and Treatment of Newly Diagnosed and Recurrent Childhood Brain Tumors Astrocytomas and Other Tumors of Glial Origin –Low-Grade AstrocytomasDiffuse fibrillary astrocytomaSeeChildhood Astrocytomas Treatmentfor information on low-grade astrocytomas.Gemistocytic astrocytomaOligoastrocytomaOligodendrogliomaPilocytic astrocytomaPilomyxoid astrocytomaPleomorphic xanthoastrocytomaProtoplasmic
Treatment Option Overview for Neuroblastoma
Because most children with neuroblastoma in North America are treated according to the Children's Oncology Group (COG) risk-group assignment, the treatments described in this summary are based on COG risk group assignment. Each child is assigned to a low-risk, intermediate-risk, or high-risk group (refer to Tables 6, 7, and 8 for more information) based on the following:[1,2,3,4,5,6]International Neuroblastoma Staging System (INSS) stage.Age.International Neuroblastoma Pathologic Classification (INPC).Ploidy.Amplification of the MYCN oncogene within tumor tissue.[1,2,3,4,5,6]Other biological factors that influence treatment selection include unbalanced 11q loss of heterozygosity and loss of heterozygosity for chromosome 1p.[7,8]The treatment of neuroblastoma has evolved over the past 60 years. Generally, treatment is based on whether the tumor is low, intermediate, or high risk:For low-risk tumors the approach is either observation or resection, and survival is greater than
What is screening?
Screening is looking for cancer before a person has any symptoms. This can help find cancer at an early stage. When abnormal tissue or cancer is found early,it may be easier to treat. By the time symptoms appear,cancer may have begun to spread. Scientists are trying to better understand which people are more likely to get certain types of cancer. They also study the things we do and the ...
About This PDQ Summary
Purpose of This SummaryThis PDQ cancer information summary for health professionals provides comprehensive, peer-reviewed, evidence-based information about the treatment of childhood ependymoma. It is intended as a resource to inform and assist clinicians who care for cancer patients. It does not provide formal guidelines or recommendations for making health care decisions.Reviewers and UpdatesThis summary is reviewed regularly and updated as necessary by the PDQ Pediatric Treatment Editorial Board, which is editorially independent of the National Cancer Institute (NCI). The summary reflects an independent review of the literature and does not represent a policy statement of NCI or the National Institutes of Health (NIH). Board members review recently published articles each month to determine whether an article should:be discussed at a meeting,be cited with text, orreplace or update an existing article that is already cited.Changes to the summaries are made through a consensus
There is no generally recognized staging system for childhood astrocytomas. For the purposes of this summary, childhood astrocytomas will be described as low-grade astrocytoma (pilocytic astrocytomas and diffuse fibrillary astrocytomas) or high-grade astrocytoma (anaplastic astrocytomas and glioblastoma) and as untreated or recurrent.
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 Astrocytomas Treatment
Tumor growth due to maturation should be differentiated from tumor progression by performing a biopsy and reviewing histology. Patients may have persistent maturing disease with metaiodobenzylguanidine (mIBG) uptake that does not affect outcome. When neuroblastoma recurs in a child originally diagnosed with high-risk disease, the prognosis is usually poor despite additional intensive therapy.[2,3,4,5] However, it is often possible to gain many additional months of life for these patients with alternative chemotherapy regimens.[6,7] Clinical trials are appropriate for these patients and may be offered. Information about ongoing clinical trials is available from the NCI Web site.Prognostic Factors for Recurrent NeuroblastomaThe International Neuroblastoma Risk Group Project performed a decision-tree analysis of clinical and biological characteristics (defined at diagnosis) associated with survival after relapse in 2,266 patients with neuroblastoma entered on large clinical
Treatment Option Overview
There are different types of treatment for patients with adult brain and spinal cord tumors. Different types of treatment are available for patients with adult brain and spinal cord tumors. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.Four types of standard treatment are used:Watchful waitingWatchful waiting is closely monitoring a patient's condition without giving any treatment until symptoms appear or change.Surgery Surgery may be used to diagnose and treat adult brain and spinal cord tumors.
Classification of Adult Brain Tumors
This classification is based on the World Health Organization (WHO) classification of central nervous system (CNS) tumors. The WHO approach incorporates and interrelates morphology, cytogenetics, molecular genetics, and immunologic markers in an attempt to construct a cellular classification that is universally applicable and prognostically valid. Earlier attempts to develop a TNM-based classification were dropped: tumor size (T) is less relevant than tumor histology and location, nodal status (N) does not apply because the brain and spinal cord have no lymphatics, and metastatic spread (M) rarely applies because most patients with CNS neoplasms do not live long enough to develop metastatic disease.The WHO grading of CNS tumors establishes a malignancy scale based on histologic features of the tumor. The histologic