Brain Tumors
Treatment

Treatment options for primary brain tumors include:

• Surgery — When possible, surgery is performed to remove tumors.

• Radiation Therapy — This involves the use of high-dose X-rays to kill cancer cells and shrink tumors. Children with brain tumors usually receive a type of radiation therapy called external radiation therapy. This treatment is administered by a machine that directs radiation to the cancer cells. Radiation also can be administered by material implanted in the brain.

• Radiosurgery Gamma Knife — Radiosurgery is a minimally invasive option for children with small to medium tumors deep within the brain. Radiosurgery differs from conventional radiation treatment in that small, targeted doses of radiation are delivered to the brain, with little damage to surrounding tissue.

• Chemotherapy — This involves the use of drugs to kill cancer cells. Chemotherapy drugs may be taken orally or injected into a vein 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.

More than one type of treatment may be used, depending on the needs of your child. Children who undergo treatment at UCSF Children's Hospital receive specialized care from imaging studies to anesthesia to recovery provided by pediatric specialists. Your child's treatment may be coordinated by a pediatric oncologist, a doctor who specializes in brain tumor treatment in children. The oncologist may refer your child to other doctors, such as a pediatric neurosurgeon, a specialist in childhood brain surgery; pediatric neurologist; psychologist; radiation oncologist; and other doctors who specialize in treatment your child needs.

Astrocytomas

Surgery to remove all or as much of the tumor as possible is the primary treatment for childhood cerebellar astrocytoma. If the tumor can't be completely removed, radiation therapy may be given. Because radiation therapy can affect a child's growth and development, chemotherapy may be given to try to delay or eliminate the need for radiation therapy, depending on the child's age. The prognosis for children with cerebellar astrocytoma that has been completely surgically removed is generally good, with a 95 percent survival rate for five to 10 years.

Some forms of low grade astrocytoma may not be easily removed and may be treated with chemotherapy, radiation treatment or both, depending on the child's age and symptoms.

Brain Stem Gliomas

Radiation therapy is the most common treatment for brain stem gliomas. But because brain stem gliomas are an aggressive, malignant tumor, radiation is rarely a cure. UCSF Children's Hospital is participating in clinical trials — studies involving patients to test new treatments — to find ways to make radiation more effective by combining it with chemotherapy involving new anti-tumor drugs. These studies involve new and conventional chemotherapy.

Surgery is used when possible but tumors in the brain stem often can't be surgically removed. Your child's doctor may remove as much of the tumor as possible by creating an opening in the skull in an operation called a craniotomy. Surgery, however, may be limited to a biopsy. Sometimes, no surgical procedure can be performed safely, in which case the diagnosis is made based on the MRI appearance of the tumor. The prognosis for children with brain stem gliomas is generally poor, with a 10 percent survival rate two years from the time of diagnosis.

Ependymomas

Surgery is used when possible to treat ependymomas but it is often difficult to completely remove. Radiation therapy is the most common treatment for children old enough to tolerate the side effects.

Depending on the tumor's location, your child's doctor may remove as much of the tumor as possible by creating an opening in the skull in an operation called a craniotomy. If the ependymoma is in a location where it can't be removed, surgery may be limited to a biopsy or partial removal of the tumor.

Chemotherapy is being studied as a means of delaying or eliminating the need for radiation therapy in children. It's also being studied as treatment prior to or during radiation therapy. UCSF Children's Hospital is participating in clinical trials — studies involving patients to test new treatments — to find new ways of using radiation treatment to reduce the side effects. The prognosis for children with ependymomas varies widely, depending on the characteristics of the tumor and other factors.

Medulloblastoma

Treatment for medullobastoma requires surgery, radiation treatment in children old enough to tolerate the side effects and chemotherapy. Surgery is performed to remove as much of the tumor as possible. If the cancer is in a location where it can't be removed, surgery may be limited to a biopsy or partial removal of the tumor. Because radiation therapy can affect growth and brain development in children, UCSF Children's Hospital is participating in clinical trials — studies involving patients to test new treatments — to find ways ways to decrease or delay radiation therapy, especially for younger children.

Researchers are studying chemotherapy drugs for childhood medulloblastoma. Stem cell transplants, which return a child's blood cells after high-dose chemotherapy, may be considered if your child's tumor recurs after surgery, radiation and chemotherapy, or if your child is very young and at risk for complications from standard radiation therapy.

The prognosis of medullobastoma varies. Several factors to consider include:

• Age of your child at the time of diagnosis
• Amount of tumor that can be removed
• If the tumor has spread beyond the primary site at the time of diagnosis

The Social Security Administration, through the Supplemental Security Income (SSI) program, provides monthly payments to needy families of disabled children. Children with cancer may qualify. Typically, there's a two to four month application process. Please contact your local Social Security Administration office for more information.

Reviewed by health care specialists at UCSF Children's Hospital.
Last updated March 10, 2010