Untreated Childhood Cerebellar Astrocytoma
Surgical resection is the primary treatment for childhood cerebellar astrocytoma.[1,2,3] Complete or near complete removal can be obtained in 90% to 95% of patients with juvenile pilocytic tumors. Diffuse cerebellar astrocytomas may be less amenable to total resection, and this may account for the poorer outcome. The extent of resection necessary for cure is unknown because patients with microscopic and even gross residual tumor after surgery may experience long-term progression-free survival without postoperative therapy.[3,4] Following resection, a postoperative MRI is obtained. Surveillance scans are then obtained periodically for totally resected tumors, although the value of this is uncertain. The optimal use of radiation therapy is the subject of controversy. Treatment is often withheld in patients with residual disease until tumor progression has been documented. Chemotherapy may be useful for delaying radiation therapy in the very young child with unresectable, progressive cerebellar astrocytoma.
Current Clinical Trials
Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with untreated childhood cerebellar astrocytoma. 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.
- Campbell JW, Pollack IF: Cerebellar astrocytomas in children. J Neurooncol 28 (2-3): 223-31, 1996 May-Jun.
- Schneider JH Jr, Raffel C, McComb JG: Benign cerebellar astrocytomas of childhood. Neurosurgery 30 (1): 58-62; discussion 62-3, 1992.
- Due-Tønnessen BJ, Helseth E, Scheie D, et al.: Long-term outcome after resection of benign cerebellar astrocytomas in children and young adults (0-19 years): report of 110 consecutive cases. Pediatr Neurosurg 37 (2): 71-80, 2002.
- Hayostek CJ, Shaw EG, Scheithauer B, et al.: Astrocytomas of the cerebellum. A comparative clinicopathologic study of pilocytic and diffuse astrocytomas. Cancer 72 (3): 856-69, 1993.
- Sutton LN, Cnaan A, Klatt L, et al.: Postoperative surveillance imaging in children with cerebellar astrocytomas. J Neurosurg 84 (5): 721-5, 1996.
- Garcia DM, Marks JE, Latifi HR, et al.: Childhood cerebellar astrocytomas: is there a role for postoperative irradiation? Int J Radiat Oncol Biol Phys 18 (4): 815-8, 1990.
- Packer RJ, Lange B, Ater J, et al.: Carboplatin and vincristine for recurrent and newly diagnosed low-grade gliomas of childhood. J Clin Oncol 11 (5): 850-6, 1993.