Treatment Option Overview for Childhood Brain Stem Glioma
Many of the improvements in survival in childhood cancer have been made as a result of clinical trials that have attempted to improve on the best available, accepted therapy. Clinical trials in pediatrics are designed to compare new therapy with therapy that is currently accepted as standard. This comparison may be done in a randomized study of two treatment arms or by evaluating a single new treatment and comparing the results with those that were previously obtained with existing therapy.
Because of the relative rarity of cancer in children, all patients with brain tumors should be considered for entry into a clinical trial. To determine and implement optimum treatment, planning by a multidisciplinary team of cancer specialists who have experience treating childhood brain tumors is required. Radiation therapy (including 3-dimensional conformal radiation therapy) of pediatric brain tumors is technically very demanding and should be carried out in centers that have experience in that area in order to ensure optimal results.
|Stage||Standard Treatment Options|
|Newly diagnosed childhood brain stem gliomas:|
|Diffuse intrinsic pontine gliomas||Radiation therapy|
|Focal or low-grade brain stem gliomas||Surgical resection (with or without radiation therapy and chemotherapy)|
|Observation (with or without cerebrospinal fluid diversion)|
|Radiation therapy, chemotherapy, and alternative approaches for inoperable focal or low-grade tumors|
|Recurrent/progressive childhood brain stem gliomas:|
|Diffuse intrinsic pontine gliomas||Palliative care|
|Focal or low-grade brain stem gliomas||Repeat surgical resection|