Brain Stem Gliomas
Pineal Astrocytic Tumors
Pilocytic Astrocytomas
Diffuse Astrocytomas
Anaplastic Astrocytomas
Glioblastoma
Oligodendroglial Tumors
Mixed Gliomas
Ependymal Tumors
Medulloblastoma
Pineal Parenchymal Tumors
Meningeal Tumors
Germ Cell Tumors
Craniopharyngioma
Recurrent Adult Brain Tumor
Metastatic Brain Tumors

Brain Stem Gliomas

Treatment of brain stem gliomas may include the following:

1. Hyperfractionated radiation therapy.
2. A clinical trial of new anticancer drugs and/or biologic therapy.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with adult brain stem glioma ¹.

Treatment of pineal astrocytic tumors may include the following:

1. Surgery and radiation therapy, with or without chemotherapy.
2. A clinical trial of external radiation therapy plus hyperthermia therapy or new methods of delivering radiation therapy.
3. A clinical trial of new anticancer drugs and biologic therapy following radiation therapy.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with adult pineal gland astrocytoma ².

Treatment of pilocytic astrocytoma is usually surgery with or without radiation therapy.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with adult pilocytic astrocytoma ³.

Treatment of diffuse astrocytoma may include the following:

1. Surgery, usually with radiation therapy.
2. A clinical trial of surgery and radiation therapy with or without chemotherapy for tumors that cannot be completely removed by surgery.
3. A clinical trial of radiation therapy delayed until the tumor progresses.
4. A clinical trial comparing high- dose and low-dose radiation therapy.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with adult diffuse astrocytoma ⁴.

Treatment of anaplastic astrocytoma may include the following:

1. Surgery plus radiation therapy, with or without chemotherapy.
2. A clinical trial of external radiation therapy plus hyperthermia therapy or new methods of delivering radiation therapy.
3. A clinical trial of new anticancer drugs and biologic therapy following radiation therapy.
4. A clinical trial of chemotherapy combined with different methods of delivering radiation therapy.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with adult anaplastic astrocytoma ⁵.

Treatment of glioblastoma may include the following:

1. Surgery plus radiation therapy, with or without chemotherapy.
2. A clinical trial of chemotherapy placed into the brain during surgery.
3. A clinical trial of radiation and concurrent chemotherapy.
4. A clinical trial of external radiation therapy plus hyperthermia therapy or new methods of delivering radiation therapy.
5. A clinical trial of new anticancer drugs and biologic therapy following radiation therapy.
6. A clinical trial of chemotherapy and new methods of delivering radiation therapy.
7. Clinical trials of new treatments.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with adult glioblastoma ⁶.

Treatment of oligodendrogliomas may include the following:

1. Surgery, usually with radiation therapy.
2. A clinical trial of surgery and radiation therapy with or without chemotherapy for tumors that cannot be completely removed by surgery.
3. A clinical trial of chemotherapy using one or more drugs.

Treatment of anaplastic oligodendroglioma may include the following:

1. Surgery plus radiation therapy with or without chemotherapy.
2. Chemotherapy using more than one drug.
3. Radiation therapy with or without chemotherapy using more than one drug.
4. Clinical trials of new treatments.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with adult oligodendroglial tumors ⁷.

Treatment of mixed gliomas may include the following:

1. Surgery plus radiation therapy with or without chemotherapy.
2. A clinical trial of external radiation therapy plus hyperthermia therapy or new methods of delivering radiation therapy.
3. A clinical trial of new anticancer drugs or biologic therapy following radiation therapy.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with mixed gliomas ⁸.

Treatment of grade I and grade II ependymomas is usually surgery with or without radiation therapy.

Treatment of anaplastic ependymoma may include the following:

1. Surgery plus radiation therapy.
2. A clinical trial of surgery followed by chemotherapy before, during, and after radiation therapy.
3. A clinical trial of chemotherapy and/or biologic therapy.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with adult ependymal tumors ⁹.

Treatment of medulloblastomas may include the following:

1. Surgery plus radiation therapy to the brain and spine.
2. A clinical trial of surgery and radiation therapy to the brain and spine for tumors that are more difficult to treat successfully.
3. A clinical trial of chemotherapy.

(Refer to the PDQ summary on Childhood Medulloblastoma Treatment ¹⁰ for more information.)

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with adult medulloblastoma ¹¹.

Treatment of pineal parenchymal tumors may include the following:

1. Surgery plus radiation therapy with or without chemotherapy.
2. A clinical trial of external radiation therapy plus hyperthermia therapy or new methods of delivering radiation therapy.
3. A clinical trial of new anticancer drugs and biologic therapy following radiation therapy.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with adult pineal parenchymal tumor ¹².

Treatment of meningiomas may include the following:

1. Surgery with or without radiation therapy.
2. Radiation therapy for tumors that cannot be removed by surgery.

Treatment of malignant meningioma may include the following:

1. Surgery plus radiation therapy.
2. A clinical trial of external radiation therapy plus hyperthermia therapy or new methods of delivering radiation therapy.
3. A clinical trial of new anticancer drugs and/or biologic therapy following radiation therapy.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with adult meningeal tumor ¹³.

Treatment of central nervous system germ cell tumors depends on the type of cancer cells, the location of the tumor, whether the cancer can be removed in an operation, and other factors.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with adult central nervous system germ cell tumor ¹⁴.

Treatment of craniopharyngiomas may include the following:

1. Surgery to remove the entire tumor.
2. Surgery to remove as much of the tumor as possible, followed by radiation therapy.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with adult craniopharyngioma ¹⁵.

Treatment of recurrent adult brain tumors may include the following:

1. Surgery with or without chemotherapy.
2. Radiation therapy, if not used during previous treatment, with or without chemotherapy.
3. Internal radiation therapy.
4. Chemotherapy.
5. A clinical trial of new anticancer drugs.
6. A clinical trial of chemotherapy placed into the brain during surgery.
7. A clinical trial of biologic therapy.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with recurrent adult brain tumor ¹⁶.

Treatment of a single metastatic brain tumor is usually surgery followed by radiation therapy to the brain.

Treatment of more than one metastatic brain tumor may include the following:

1. Radiation therapy to the brain.
2. Surgery, for large tumors that are pressing on areas of the brain and causing symptoms.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with adult tumors metastatic to brain ¹⁷.

Glossary Terms

A term used to describe cancer cells that divide rapidly and have little or no resemblance to normal cells.

A tumor that begins in the brain or spinal cord in small, star-shaped cells called astrocytes.

Treatment to boost or restore the ability of the immune system to fight cancer, infections, and other diseases. Also used to lessen certain side effects that may be caused by some cancer treatments. Agents used in biological therapy include monoclonal antibodies, growth factors, and vaccines. These agents may also have a direct antitumor effect. Also called immunotherapy, biotherapy, biological response modifier therapy, and BRM therapy.

A tumor located in the part of the brain that connects to the spinal cord (the brain stem). It may grow rapidly or slowly, depending on the grade of the tumor.

The growth of abnormal cells in the tissues of the brain. Brain tumors can be benign (non-cancerous) or malignant (cancerous).

A term for diseases in which abnormal cells divide without control. Cancer cells can invade nearby tissues and can spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord.

The individual unit that makes up the tissues of the body. All living things are made up of one or more cells.

CNS. The brain and spinal cord. Also called CNS.

Treatment with drugs that kill cancer cells.

A type of research study that tests how well new medical approaches work in people. These studies test new methods of screening, prevention, diagnosis, or treatment of a disease. Also called a clinical study.

A treatment that is given at the same time as another.

A benign brain tumor that may be considered malignant because it can damage the hypothalamus, the area of the brain that controls body temperature, hunger, and thirst.

Widely spread; not localized or confined.

The amount of medicine taken, or radiation given, at one time.

Any substance, other than food, that is used to prevent, diagnose, treat or relieve symptoms of a disease or abnormal condition. Also refers to a substance that alters mood or body function, or that can be habit-forming or addictive, especially a narcotic.

A type of brain tumor that begins in cells lining the spinal cord central canal (fluid-filled space down the center) or the ventricles (fluid-filled spaces of the brain). Ependymomas may also form in the choroid plexus (tissue in the ventricles that makes cerebrospinal fluid). Also called ependymal tumor.

A type of radiation therapy that uses a machine to aim high-energy rays at the cancer from outside of the body. Also called external-beam radiation therapy.

A type of tumor that begins in the cells that give rise to sperm or eggs. Germ cell tumors can occur almost anywhere in the body and can be either benign or malignant.

A fast-growing type of central nervous system tumor that forms from glial (supportive) tissue of the brain and spinal cord and has cells that look very different from normal cells. Glioblastoma usually occurs in adults and affects the brain more often than the spinal cord. Also called grade IV astrocytoma, glioblastoma multiforme, and GBM.

The grade of a tumor depends on how abnormal the cancer cells look under a microscope and how quickly the tumor is likely to grow and spread. Grading systems are different for each type of cancer.

Radiation therapy that gives smaller doses (fractions) of radiation more often than standard radiation therapy so that the full treatment course can be given with fewer side effects. In hyperfractionation, individual doses are given more often than the standard dose of once a day. Also called hyperfractionated radiation therapy and superfractionated radiation therapy.

A type of treatment in which body tissue is exposed to high temperatures to damage and kill cancer cells or to make cancer cells more sensitive to the effects of radiation and certain anticancer drugs.

A type of radiation therapy in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near a tumor. Also called brachytherapy, radiation brachytherapy, and implant radiation therapy.

A rare, fast-growing tumor that forms in one of the inner layers of the meninges (thin layers of tissue that cover and protect the brain and spinal cord). Malignant meningioma often spreads to other areas of the body.

A malignant brain tumor that begins in the lower part of the brain and that can spread to the spine or to other parts of the body. Medulloblastomas are a type of primitive neuroectodermal tumor (PNET).

A type of slow-growing tumor that forms in the meninges (thin layers of tissue that cover and protect the brain and spinal cord). Meningiomas usually occur in adults.

Having to do with metastasis, which is the spread of cancer from one part of the body to another.

A brain tumor that forms from more than one type of brain cell, usually astrocytes and oligodendrocytes.

A rare, slow-growing tumor that begins in oligodendrocytes (cells that cover and protect nerve cells in the brain and spinal cord). Also called oligodendroglial tumor.

The essential or functional elements of an organ.

PDQ is an online database developed and maintained by the National Cancer Institute. Designed to make the most current, credible, and accurate cancer information available to health professionals and the public, PDQ contains peer-reviewed summaries on cancer treatment, screening, prevention, genetics, complementary and alternative medicine, and supportive care; a registry of cancer clinical trials from around the world; and directories of physicians, professionals who provide genetics services, and organizations that provide cancer care. Most of this information, and more specific information about PDQ, can be found on the NCI's Web site at http://www.cancer.gov/cancertopics/pdq. Also called Physician Data Query.

Made up of cells that look like fibers when viewed under a microscope.

A tiny organ in the cerebrum that produces melatonin. Also called pineal body or pineal organ.

A type of brain tumor that occurs in or around the pineal gland, a tiny organ near the center of the brain.

In medicine, the course of a disease, such as cancer, as it becomes worse or spreads in the body.

The use of high-energy radiation from x-rays, gamma rays, neutrons, protons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body. Also called radiotherapy and irradiation.

Cancer that has recurred (come back), usually after a period of time during which the cancer could not be detected. The cancer may come back to the same place as the original (primary) tumor or to another place in the body. Also called recurrent cancer.

The bones, muscles, tendons, and other tissues that reach from the base of the skull to the tailbone. The spine encloses the spinal cord and the fluid surrounding the spinal cord. Also called backbone, spinal column, and vertebral column.

A procedure to remove or repair a part of the body or to find out whether disease is present. An operation.

An indication that a person has a condition or disease. Some examples of symptoms are headache, fever, fatigue, nausea, vomiting, and pain.

An abnormal mass of tissue that results when cells divide more than they should or do not die when they should. Tumors may be benign (not cancerous), or malignant (cancerous). Also called neoplasm.