Astrocytic Tumors
        Brain Stem Gliomas
        Pineal Astrocytic Tumors
        Pilocytic Astrocytomas
        Diffuse Astrocytomas
        Anaplastic Astrocytomas
        Glioblastoma
Oligodendroglial Tumors
Mixed Gliomas
Ependymal Tumors
Embryonal Cell Tumors: Medulloblastoma
Pineal Parenchymal Tumors
Meningeal Tumors
Germ Cell Tumors
Tumors of the Sellar Region: Craniopharyngioma
Recurrent Brain Tumors
Metastatic Brain Tumors

A link to a list of current clinical trials is included for each treatment section. For some types or stages of cancer, there may not be any trials listed. Check with your doctor for clinical trials that are not listed here but may be right for you.

Treatment of brain stem gliomas is radiation therapy, including hyperfractionated radiation 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. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site ².

Treatment of pineal astrocytic tumors may include the following:

• Surgery and radiation therapy, with or without chemotherapy.
• A clinical trial of external radiation therapy with or without radiosensitizers, intraoperative radiation therapy, or hyperthermia therapy.
• A clinical trial of external radiation therapy, followed by new anticancer drugs and biologic 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 ³. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site 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 ⁴. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site ².

Treatment of diffuse astrocytoma may include the following:

• Surgery with or without radiation therapy.
• A clinical trial of radiation therapy with or without chemotherapy for tumors that could not be completely removed by surgery.
• A clinical trial of radiation therapy given when the tumor progresses.
• A clinical trial to compare 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 ⁵. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site ².

Treatment of anaplastic astrocytoma may include the following:

• Surgery and radiation therapy, with or without chemotherapy.
• A clinical trial of external radiation therapy and one of the following:
  • Hyperfractionated radiation therapy.
  • Accelerated-fraction radiation therapy.
  • Stereotactic radiosurgery.
  • Radiosensitizers.
  • Hyperthermia therapy.
  • Internal radiation therapy.
  • Intraoperative radiation therapy.
• A clinical trial of external radiation therapy, followed by new anticancer drugs and biologic therapy.
• A clinical trial of chemotherapy combined with hyperfractionated radiation therapy or internal and external radiation therapy.
• A clinical trial of chemotherapy placed into the brain during surgery.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with adult anaplastic astrocytoma ⁶. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site ².

Treatment of glioblastoma may include the following:

• Surgery and radiation therapy, with or without chemotherapy.
• Chemotherapy placed into the brain during surgery.
• Radiation therapy given at the same time as chemotherapy.
• A clinical trial of external radiation therapy and one of the following:
  • Hyperfractionated radiation therapy.
  • Accelerated-fraction radiation therapy.
  • Stereotactic radiosurgery.
  • Radiosensitizers.
  • Hyperthermia therapy.
  • Internal radiation therapy.
  • Intraoperative radiation therapy.
• A clinical trial of external radiation therapy, followed by new anticancer drugs and biologic therapy.
• A clinical trial of a new treatment.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with adult glioblastoma ⁷. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site ².

Treatment of oligodendrogliomas may include the following:

• Surgery with or without radiation therapy.
• Chemotherapy.
• A clinical trial of radiation therapy with or without chemotherapy, for tumors that could not be completely removed by surgery.
• A clinical trial of chemotherapy.

Treatment of anaplastic oligodendroglioma may include the following:

• Surgery and radiation therapy, with or without chemotherapy.
• Combination chemotherapy.
• Radiation therapy with or without combination chemotherapy.
• A clinical trial of a new treatment.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with adult oligodendroglial tumors ⁸. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site ².

Treatment of mixed gliomas may include the following:

• Surgery and radiation therapy, with or without chemotherapy.
• Chemotherapy.
• A clinical trial of external radiation therapy and one of the following:
  • Internal radiation therapy.
  • Radiosensitizers.
  • Hyperthermia therapy.
  • Intraoperative radiation therapy.
• A clinical trial of external radiation therapy, followed by new anticancer drugs and biologic therapy.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with adult mixed glioma ⁹. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site ².

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

Treatment of grade III anaplastic ependymoma may include the following:

• Surgery and radiation therapy.
• A clinical trial of chemotherapy before, during, or after radiation therapy.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with adult ependymal tumors ¹⁰. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site ².

Treatment of medulloblastomas may include the following:

• Surgery and radiation therapy to the brain and spine.
• Chemotherapy.
• A clinical trial of surgery and radiation therapy to the brain and spine.
• A clinical trial of chemotherapy.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with adult medulloblastoma ¹¹. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site ².

Treatment of pineal parenchymal tumors may include the following:

• Surgery and radiation therapy, for pineocytomas.
• Surgery, radiation therapy, and chemotherapy, for pineoblastomas.
• A clinical trial of external radiation therapy and one of the following:
  • Radiosensitizers.
  • Hyperthermia therapy.
  • Intraoperative radiation therapy.
• A clinical trial of external radiation therapy, followed by new anticancer drugs and biologic 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. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site ².

Treatment of grade I meningiomas may include the following:

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

Treatment of grade II and III meningioma and hemangiopericytoma may include the following:

• Surgery and radiation therapy.
• A clinical trial of external radiation therapy and one of the following:
  • Internal radiation therapy.
  • Radiosensitizers.
  • Hyperthermia therapy.
  • Intraoperative radiation therapy.
• A clinical trial of external radiation therapy, followed by new anticancer drugs and biologic 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. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site ².

Treatment of a germinoma is usually radiation therapy. For treatment of a teratoma that has not spread, surgery is used. There is no standard treatment for other types of germ cell tumors.

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. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site ².

Treatment of craniopharyngiomas may include the following:

• Surgery to remove the whole tumor.
• 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. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site ².

Treatment of recurrent brain tumors may include the following:

• Surgery with or without chemotherapy.
• Radiation therapy, if not used before, with or without chemotherapy.
• A second surgery followed by radiation therapy, if not used before, or chemotherapy.
• Internal radiation therapy.
• Chemotherapy.
• A clinical trial of a new anticancer drug with or without biologic therapy.
• A clinical trial of chemotherapy placed into the brain during surgery.
• 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. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site ².

Treatment of a single tumor that has spread to the brain from another part of the body is usually surgery followed by radiation therapy to the whole brain.

Treatment of more than one tumor that has spread to the brain from another part of the body may include the following:

• Radiation therapy to the whole brain with or without stereotactic radiosurgery.
• Surgery, for tumors that are causing symptoms.
• Surgery to remove a tissue sample when the type of primary tumor is not known.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with tumors metastatic to brain ¹⁷. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site ².

Glossary Terms

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

A large, star-shaped cell that holds nerve cells in place and helps them develop and work the way they should. An astrocyte is a type of glial cell.

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 biological response modifier therapy, biotherapy, BRM therapy, and immunotherapy.

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 (not cancer) or malignant (cancer).

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 clinical study.

Treatment using more than one anticancer drug.

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.

The most common type of germ cell tumor in the brain.

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 GBM, glioblastoma multiforme, and grade IV astrocytoma.

A description of a tumor based 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.

A type of cancer involving blood vessels and soft tissue.

An amount of radiation that is greater than that given in typical radiation therapy. High-dose radiation is precisely directed at the tumor to avoid damaging healthy tissue, and may kill more cancer cells in fewer treatments. Also called HDR.

Radiation treatment in which the total dose of radiation is divided into small doses and treatments are given more than once a day. Also called hyperfractionation and superfractionated radiation therapy.

Abnormally high body temperature. This may be caused as part of treatment, by an infection, or by exposure to heat.

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, implant radiation therapy, and radiation brachytherapy.

Radiation treatment aimed directly at a tumor during surgery. Also called IORT.

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.

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.

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 and pineal organ.

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

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

The original tumor.

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 irradiation and radiotherapy.

A drug that makes tumor cells more sensitive to radiation therapy. Also called radiosensitizing agent.

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 recurrence.

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.

The extent of a cancer in the body. Staging is usually based on the size of the tumor, whether lymph nodes contain cancer, and whether the cancer has spread from the original site to other parts of the body.

In medicine, treatment that experts agree is appropriate, accepted, and widely used. Health care providers are obligated to provide patients with standard therapy. Also called best practice and standard of care.

A type of external radiation therapy that uses special equipment to position the patient and precisely give a single large dose of radiation to a tumor. It is used to treat brain tumors and other brain disorders that cannot be treated by regular surgery. It is also being studied in the treatment of other types of cancer. Also called radiation surgery, radiosurgery, and stereotaxic radiosurgery.

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.

A type of germ cell tumor that may contain several different types of tissue, such as hair, muscle, and bone. Teratomas occur most often in the ovaries in women, the testicles in men, and the tailbone in children. Not all teratomas are malignant.

A group or layer of cells that work together to perform a specific function.

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 cancer), or malignant (cancer). Also called neoplasm.