Pediatric Brain and Spine Tumors
There are treatments for all children with brain tumors. Three kinds of treatment are used:
- surgery (removing the tumor in an operation)
- radiation therapy (using high-dose x-rays to kill tumor cells)
- chemotherapy (using drugs to kill tumor cells)
More than one method of treatment may be used, depending on the needs of the patient.
Experienced doctors working together may provide the best treatment for children with brain tumors. Your child's treatment will often be coordinated by the neuro-oncology team. Florida Hospital has the original pediatric neuro-oncology clinic in Central Florida, a team that includes a pediatric oncologist, a doctor who specializes in cancer in children. A pediatric neurosurgeon (a specialist in childhood brain surgery), a pediatric neurologist, a psychologist, a radiation oncologist, and other doctors who specialize in the type of treatment your child requires.
Treatment options often depend on the type of tumor and its location within the brain. Complete or near complete removal of the tumor is often possible. If the tumor cannot be completely removed, radiation therapy and/or chemotherapy may also be given.
Radiation therapy uses high-energy radiation from x-rays and other sources to kill cancer cells and shrink tumors. Radiation therapy for childhood brain tumors usually comes from a machine outside the body (external radiation therapy). For some types of brain tumors, clinical trials are evaluating radiation therapy given in several small doses per day (hyperfractionated radiation therapy). Since radiation therapy can affect growth and brain development, other clinical trials are testing ways to decrease or delay radiation therapy, especially for younger children who have not yet achieved full growth. Concern about radiation damage to the developing brain has led Florida Hospital to employ the Gamma Knife, which provides focused radiation therapy, performed by the pediatric neurosurgeon and radiation oncologist. Not all patients are Gamma Knife candidates For more information about the Florida Hospital Gamma Knife program, click here.
Chemotherapy is the use of drugs to kill cancer cells. Chemotherapy drugs may be taken by mouth or injected into a vein (intravenous) or muscle. Chemotherapy is called a systemic treatment because the drug enters the bloodstream, travels through the body, and can kill cancer cells throughout the body. Chemotherapy is being studied in clinical trials as a means of delaying, modifying or eliminating the need for radiation therapy in younger patients, as well as for use prior to or during radiation therapy.
To view Dr. Trumble's Neuro-Oncology clinical presentation, click here. (Viewer Discretion Advised: The presentation contain graphic medical imagery)
Pediatric Brain Tumor Treatment by Type
Treatment for childhood brain tumor depends on the type and grade of the tumor, its location within the brain, and your child's age and overall health.
Your child may receive treatment that is considered standard based on its effectiveness in a number of patients in past studies, or you may choose to have your child enter a clinical trial. Not all patients are cured with standard therapy and some standard treatments may have more side effects than are desired. For these reasons, clinical trials are designed to test new treatments and to find better ways to treat people with cancer. Clinical trials are ongoing in most parts of the country for childhood brain tumors. For more information, call the Cancer Information Service at 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615.
Childhood Infratentorial Ependymoma
Treatment for childhood infratentorial ependymoma is usually surgery to remove as much of the tumor as possible, followed by radiation therapy. For children younger than 3 years of age, chemotherapy may be given to delay, modify, or eliminate the use of radiation therapy.
Childhood Supratentorial Ependymoma
Treatment for childhood supratentorial ependymoma may be surgery followed by radiation therapy. Clinical trials are evaluating surgery followed by chemotherapy with or without radiation therapy. For children younger than 3 years of age, chemotherapy may be given to delay or modify the use of radiation therapy. Clinical trials evaluating radiation therapy with or without chemotherapy are ongoing.
Childhood Craniopharyngioma
Treatment for childhood craniopharyngioma may be surgery, radiation therapy, or a combination of the two.
Childhood Central Nervous System Germ Cell Tumor
Treatment for childhood central nervous system germ cell tumor may be radiation therapy. In some cases, chemotherapy may be given in addition to radiation therapy.
Recurrent Childhood Brain Tumor
Treatment for recurrent disease depends on the type of tumor, whether the tumor recurs in the site in which it originated or elsewhere, the amount of time between initial treatment and the recurrence, and the type of treatment previously given.
- Recurrent low-grade glial tumors: Treatment options consist of surgery, radiation therapy, and chemotherapy. Clinical trials are currently evaluating the role of chemotherapy for treatment of these tumors.
- Recurrent infratentorial ependymomas: Treatment options include surgery and chemotherapy. Clinical trials are currently evaluating the role of chemotherapy for treatment of these tumors.
- Recurrent supratentorial ependymoma: Treatment usually consists of chemotherapy. Clinical trials are currently evaluating the role of chemotherapy for treatment of these tumors.
- Recurrent central nervous system germ cell tumors: Treatment usually consists of chemotherapy. Clinical trials are currently evaluating the role of chemotherapy for treatment of these tumors.
If you want to know more about cancer and how it is treated, or if you wish to know about clinical trials for your type of cancer, you can call the NCI's Cancer Information Service at 1-800-422-6237, toll free. A trained information specialist can talk with you and answer your questions.
To view Dr. Trumble's Neuro-Oncology clinical presentation, click here.
