Skip to content
My WebMD Sign In, Sign Up

Brain Cancer Health Center

Font Size

Childhood Brain Stem Glioma Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Untreated Childhood Brain Stem Glioma

Diffuse Intrinsic Pontine Gliomas

Conventional treatment for children with diffuse intrinsic pontine glioma (DIPG) is radiation therapy to involved areas. Such treatment will result in transient benefit for most patients, but over 90% of patients will die within 18 months of diagnosis. The conventional dose of radiation therapy ranges between 54 Gy and 60 Gy given locally to the primary tumor site in single daily fractions.

Recommended Related to Brain Cancer

Treatment Option Overview

There are different types of treatment for children with craniopharyngioma. Different types of treatments are available for children with craniopharyngioma. 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 tumors. When clinical trials show that a new treatment is better than the standard treatment,...

Read the Treatment Option Overview article > >

Hyperfractionated (twice daily) radiation therapy techniques have been used to deliver a higher dose, and studies using doses as high as 78 Gy have been completed. Evidence demonstrates that these increased radiation therapy doses do not improve the duration or rate of survival for patients with DIPG whether given alone,[1,2] or in combination with chemotherapy.[3] Hypofractionated radiation therapy does not improve survival.[4][Level of evidence: 2A] Studies evaluating the efficacy of various radiosensitizers as a means for enhancing the therapeutic effect of this modality have been undertaken but to date have failed to show any significant improvement in outcome.[2,3,5,6,7] Radiation-induced changes may occur a few months after the completion of radiation therapy and may mimic tumor progression. When considering the efficacy of additional treatment, care needs to be taken to separate radiation-induced change from progressive disease.[8]

The utility of chemotherapy in the treatment of patients with newly diagnosed DIPG is unproven.[2,3,6,7,9,10,11]; [12,13][Level of evidence: 2A]; [14][Level of evidence: 3iiiA] Currently, no chemotherapeutic strategy—including neoadjuvant, concurrent, post-radiation survival or immunotherapy—when added to radiation therapy has led to long-term survival for children with DIPG.[15,16,17]; [18][Level of evidence: 2A] Similarly, studies utilizing high-dose, marrow-ablative chemotherapy with autologous hematopoietic stem cell rescue have been ineffective in extending survival.[19] Consonant with other brain tumors, radiation therapy is often omitted for infants with DIPG and chemotherapy-only approaches are utilized.

Focal or Low-Grade Brain Stem Gliomas

In general, maximal surgical resection should be attempted.[20,21] Patients with residual tumors may be candidates for additional therapy including 3-dimensional conformal radiation therapy approaches with or without adjuvant chemotherapy. Information about ongoing clinical trials is available from the NCI Web site.

Patients with small tectal lesions and hydrocephalus but no other neurological deficits may be treated with cerebrospinal fluid diversion alone and have follow-up with sequential neuroradiographic studies unless there is evidence of progressive disease.[20]


Children with neurofibromatosis type I and brain stem gliomas may have a different prognosis than other patients who have intrinsic lesions. Patients with neurofibromatosis may present with a long history of symptoms or be identified on screening tests; a period of observation may be indicated before instituting any treatment.[22] Brain stem gliomas in these children may be indolent and may require no specific treatment for years.[23]


WebMD Public Information from the National Cancer Institute

Last Updated: February 25, 2014
This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.
Next Article:

Today on WebMD

human brain xray
Computed Tomography CT Scan Of The Head
Integrative Medicine Cancer Quiz
what is your cancer risk
Health Check

Malignant Gliomas
Pets Improve Your Health
Headache Emergencies
life after a brain tumor

Would you consider trying alternative or complementary therapies?

WebMD Special Sections