Treatments for Thalamic Astrocytoma and Hypothalamic Astrocytoma in Children

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Contact the Glioma Program

Children with thalamic/hypothalamic astrocytomas are treated through the Glioma Program at Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, an integrated pediatric hematology and oncology partnership between Dana-Farber Cancer Institute and Boston Children’s Hospital. The Pediatric Glioma Program at Dana-Farber/Boston Children’s a world-renowned destination for children with low-grade and high-grade gliomas.

Our physicians are focused on family-centered care. From your first visit, you’ll work with a team of professionals who are committed to supporting all of your family’s physical and psychosocial needs.

Your child’s physician will determine a specific course of astrocytoma treatment based on several factors, including:

  • your child's age, overall health and medical history
  • type, location and size of the tumor
  • extent of the disease
  • your child's tolerance for specific medications, procedures or therapies
  • how your child's doctors expect the disease to progress

There are a number of treatments we may recommend for astrocytoma. Some of them help to treat the tumor, while others are intended to address complications of the disease or side effects of the treatment. These treatments include:

Surgery for astrocytoma

The surgeons will try to get as much of the tumor out as possible, since aggressive tumor removal is associated with better long-term outcomes. Surgery often is limited due to the deep, central placement of both the thalamus and hypothalamus within the brain. In addition, removal of the whole tumor can result in damage to critical brain areas.

If the tumor recurs after initial surgical removal, or if the tumor re-grows after partial surgical removal, your child’s doctor may recommend a second attempt at removing as much of the tumor as possible.

Chemotherapy for astrocytoma

Chemotherapy is a drug treatment that works by interfering with the cancer cell's ability to grow or reproduce. Different groups of chemotherapy drugs work in different ways to fight cancer cells and shrink tumors.

A number of combinations of chemotherapy drugs are being used to stabilize and, in some cases, to shrink the size of the tumor. These include:

  • vincristine with carboplatin
  • vincristine with CCNU, procarbazine and thioguanine
  • other chemotherapy combinations

How is chemotherapy given?

Your child may receive chemotherapy:

  • orally, as a pill to swallow
  • intravenously (IV), directly to the bloodstream

Does chemotherapy cause side effects?

While chemotherapy can be quite effective in treating certain cancers, the drugs cannot tell the difference between normal healthy cells and cancer cells. Because of this, your child may experience adverse side effects during treatment. Knowing what these side effects are can help you and your child prepare for, and, in some cases, prevent these symptoms from occurring.

What are common side effects and how are side effects managed?

Common side effects to chemotherapy given for treatment of thalamic/hypothalamic astrocytomas include fatigue, headache, diarrhea and constipation. These side effects can usually be effectively managed with standard medical approaches.

Our Pediatric Brain Tumor Center also has access to specialists who deliver complementary or alternative medicines. These treatments, which may help control pain and the side effects of therapy include the following.

  • acupuncture/acupressure
  • therapeutic touch
  • massage
  • herbs
  • dietary recommendations

Talk to your child’s physician about whether complementary or alternative medicine might be a viable option.

Radiation Therapy

Our doctors may also use precisely targeted and dosed radiation therapy to kill cancer cells left behind after your child’s surgery. This treatment is important to control the local growth of tumor.

We usually don’t use radiation therapy unless your child’s tumor has regrown after chemotherapy. Due to the potential long-term side effects of radiation therapy, including effects on learning and hormone function, it is best avoided if your child is younger (especially under age 10-years-old).

What is the long-term outlook for thalamic/hypothalamic astrocytoma?

Fortunately, children with astrocytomas of the thalamus and/or hypothalamus have a high rate of survival. The survival rate is not as high if the tumor can’t be removed completely during surgery or if it returns.

There are many standard and experimental treatment options for children with progressive or recurrent low-grade astrocytomas, including thalamic/hypothalamic astrocytomas.

Resources & support

There are also a number of resources and support services at Dana-Farber/Boston Children's Cancer and Blood Disorders Center to help you and your family through this difficult time.

When appropriate, our Pediatric Advanced Care Team (PACT) offers supportive treatments intended to optimize the quality of life and promote healing and comfort for children with life-threatening illness. PACT also can provide psychosocial support and help arrange end-of-life care when necessary.

Long-term follow-up

Today, the majority of children and adolescents diagnosed with pediatric brain tumors will survive into adulthood. However, many of them will face physical, psychological, social and intellectual challenges related to their treatment and will require ongoing assessment and specialized care.

To address the needs of this growing community of brain tumor survivors, Dana-Farber/Boston Children's Cancer and Blood Disorders Center established a childhood brain tumor survivorship program through the Stop & Shop Family Pediatric Neuro-Oncology Outcomes Clinic.

More than 1,000 pediatric brain tumor survivors of all ages are followed by the Outcomes Clinic, a multidisciplinary program designed to address long-term health and social issues for families and survivors of childhood brain tumors. Some of the post-treatment services provided by the Outcomes Clinic include:

  • MRI scans to monitor for tumor recurrences
  • intellectual function evaluation
  • endocrine evaluation and treatment
  • neurologic assessment
  • psychosocial care
  • hearing and vision monitoring
  • ovarian dysfunction evaluation and treatment
  • motor function evaluation and physical therapy
  • complementary medicine

As a result of treatment, children may experience changes in intellectual and motor function. Among several programs addressing these needs are the School Liaison and Back to School programs, which provide individualized services to ease children's return to school and maximize their ability to learn.

In addition to providing thorough and compassionate care, our Outcomes Clinic specialists conduct innovative survivorship research and provide continuing education for staff, patients and families.

To learn more about our services; to talk to us or schedule an appointment, please call us at 617-632-2680.

We are grateful to have been ranked #1 on U.S. News & World Report's list of the best children's hospitals in the nation for the third year in a row, an honor we could not have achieved without the patients and families who inspire us to do our very best for them. Thanks to you, Boston Children's is a place where we can write the greatest children's stories ever told.”
- Sandra L. Fenwick, President and CEO

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