Neuroblastoma Screening (PDQ®): Screening - Patient Information [NCI] - Changes to This Summary (08 / 28 / 2014)
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.Images were added to this summary and editorial changes were made.
Neuroblastoma Screening (PDQ®): Screening - Patient Information [NCI] - Cellular Classification of Childhood Brain Stem Glioma
Brain stem gliomas are classified according to their location, radiographic appearance, and histology (when obtained). Brain stem gliomas may occur in the pons, midbrain, tectum, dorsum of the medulla at the cervicomedullary junction, or in multiple regions of the brain stem. The tumor may contiguously involve the cerebellar peduncles, cerebellum, the cervical spinal cord, and/or thalamus. The majority of childhood brain stem gliomas are diffuse, fibrillary astrocytomas that involve the pons (diffuse intrinsic pontine gliomas [DIPG]), often with contiguous involvement of other brain stem sites.[1,2] The prognosis is extremely poor for these tumors. Focal pilocytic astrocytomas have a more favorable prognosis. These most frequently arise in the tectum of the midbrain, focally within the pons, or at the cervicomedullary junction where they are often exophytic, and they have a far better prognosis than diffuse intrinsic tumors.[3,4,5]The genomic characteristics of DIPG appear to
About This PDQ Summary
Most patients with high-grade astrocytomas or gliomas will eventually have tumor recurrence, usually within 3 years of original diagnosis but perhaps many years after initial treatment. Disease may recur at the primary tumor site, at the margin of the resection/radiation bed, or at noncontiguous central nervous system sites. Systemic relapse is rare but may occur. At the time of recurrence, a complete evaluation for extent of relapse is indicated for all malignant tumors. Biopsy or surgical resection may be necessary for confirmation of relapse because other entities, such as secondary tumor and treatment-related brain necrosis, may be clinically indistinguishable from tumor recurrence. The need for surgical intervention must be individualized on the basis of the initial tumor type, the length of time between initial treatment and the reappearance of the mass lesion, and the clinical picture. Patients for whom initial treatment fails may benefit from additional treatment.
Childhood Ependymoma Treatment (PDQ®): Treatment - Patient Information [NCI] - Treatment Option Overview for Childhood Ependymoma
Many of the improvements in survival in childhood cancer have been made as a result of clinical trials that have attempted to improve on the best available, accepted therapy. Clinical trials in pediatrics are designed to compare new therapy with therapy that is currently accepted as standard. This comparison may be done in a randomized study of two treatment arms or by evaluating a single new treatment and comparing the results with those previously obtained with existing therapy. Because of the relative rarity of cancer in children, all patients with aggressive brain tumors should be considered for entry into a clinical trial. To determine and implement optimum treatment, treatment planning by a multidisciplinary team of cancer specialists who have experience treating childhood brain tumors is required. Radiation therapy of pediatric brain tumors is technically very demanding and should be carried out in centers that have experience in that area in order to ensure optimal results.
Childhood Brain Stem Glioma Treatment (PDQ®): Treatment - Patient Information [NCI] - Stage Information and Treatment of Newly Diagnosed and Recurrent Childhood Brain Tumors
There is no uniformly accepted staging system for childhood brain tumors. These tumors are classified and treated based on their histology and location within the brain (Table 1).Table 1. The Staging and Treatment of Newly Diagnosed or Recurrent Tumors According to Type of Tumor or Pathologic SubtypeTumor TypePathologic SubtypeStaging and Treatment of Newly Diagnosed and Recurrent DiseaseCNS = central nervous system.Astrocytomas and Other Tumors of Glial Origin –Low-Grade AstrocytomasDiffuse fibrillary astrocytomaChildhood Astrocytomas TreatmentGemistocytic astrocytomaOligoastrocytomaOligodendrogliomaPilocytic astrocytomaPilomyxoid astrocytomaPleomorphic xanthoastrocytomaProtoplasmic astrocytomaSubependymal giant cell astrocytoma–High-Grade AstrocytomasAnaplastic astrocytomaChildhood Astrocytomas TreatmentAnaplastic oligoastrocytomaAnaplastic oligodendrogliomaGiant cell glioblastomaGlioblastomaGliomatosis cerebriGliosarcoma Brain Stem
Childhood Brain Stem Glioma Treatment (PDQ®): Treatment - Patient Information [NCI] - Recurrent / Progressive Childhood Brain Stem Glioma Treatment
Diffuse Intrinsic Pontine GliomasGiven the dismal prognosis for patients with diffuse intrinsic pontine glioma, progression of the pontine lesion is anticipated generally within 1 year from initial radiation therapy. In most cases, biopsy at the time of clinical or radiologic progression is neither necessary nor recommended. To date, no salvage regimen has been shown to extend survival. Patients should be considered for entry into trials of novel therapeutic approaches because there are no standard agents that have demonstrated a clinically significant activity. Concomitant palliative care should be provided for these patients whether or not disease-directed therapy is administered. Focal or Low-Grade Brain Stem GliomasAt the time of recurrence, a complete evaluation to determine the extent of the relapse may be indicated for selected low-grade lesions. Biopsy or surgical resection should be considered for confirmation of relapse when other entities such as secondary tumor and
Childhood Ependymoma Treatment (PDQ®): Treatment - Patient Information [NCI] - Changes to This Summary (03 / 19 / 2014)
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. Stage Information for Pituitary TumorsUpdated staging information for 2010 (cited Edge et al. as reference 1).This summary is written and maintained by the PDQ Adult 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 Ependymoma Treatment (PDQ®): Treatment - Patient Information [NCI] - nci_ncicdr0000062795-nci-header
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.Neuroblastoma Screening
Childhood Ependymoma Treatment (PDQ®): Treatment - Patient Information [NCI] - Treatment Option Overview
There are different types of treatment for children with brain and spinal cord tumors. Different types of treatment are available for children with 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.Because cancer in children is rare, taking part in a clinical trial should be considered. Clinical trials are taking place in many parts of the country. Some clinical trials are open only to patients who have not started treatment. Children with brain or spinal cord tumors should have their treatment planned by a team of health care providers who are experts in treating childhood brain and spinal cord tumors.Treatment
Childhood Ependymoma Treatment (PDQ®): Treatment - Patient Information [NCI] - nci_ncicdr0000062680-nci-header
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 and Spinal Cord Tumors Treatment Overview