Children with cerebellar low-grade 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. Working together, we provide more specialists, more programs, and more clinical trials than almost any other pediatric center treating cancer and blood disorders in the world.
Your child’s physician will determine a specific course of 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
There are a number of treatments we may recommend. 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:
Doctors treat many patients with low-grade astrocytomas with surgery. If the tumor is removed, the symptoms caused by increased pressure within the brain, such as headache, vomiting and lethargy, usually go away. A child’s coordination and balance improves as well.
If a tumor can be removed surgically, your child's doctors will carefully watch for regrowth or recurrence. If the tumor does recur, or if it re-grows after partial surgical removal, your child’s doctor may recommend a second attempt at surgical removal or de-bulking of the tumor.
Chemotherapy is a drug treatment that works by interfering with tumor cells' ability to grow or reproduce. Different groups of chemotherapy drugs work in different ways to fight cancer cells and shrink tumors.
Several combinations of chemotherapy drugs are used to treat cerebellar low-grade astrocytomas, including:
- vincristine with carboplatin
- vincristine with CCNU, procarbazine and thioguanine
How is chemotherapy given?
Your child may receive chemotherapy:
- orally, as a pill to swallow
- ntramuscularly (or "IM"), as an injection into the muscle or fat tissue
- intravenously (or "IV"), directly to the bloodstream
- intrathecally, with a needle directly into the spinal fluid
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 side effects during treatment. Knowing what these side effects are can help you, your child and your care team prepare for, and, in most cases, prevent or lessen these symptoms.
What are common side effects and how are they managed?
Common side effects to chemotherapy include fatigue, headache, constipation, nausea and vomiting. 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 side effects of therapy, include the following.
- therapeutic touch
- dietary recommendations
Talk to your child’s physician about whether complementary or alternative medicine might be a viable option.
Our doctors may use precisely targeted and dosed radiation to kill cancer cells left behind after your child’s surgery. This treatment is important for controlling the local growth of tumor.
We usually don’t use radiation unless your child’s tumor does not respond to chemotherapy. Because of the potential long-term side effects of radiation, including effects on learning, hormone function and risk of second cancers, it is best avoided.
What is the long-term outlook for a child with cerebellar low-grade astrocytoma?
Grade I cerebellar astrocytomas have a 10-year survival rate of 90 to100 percent with surgical removal alone. Grade II cerebellar astrocytomas are more likely to reappear after they’ve been removed by surgery.
What about progressive or recurrent disease?
There are many standard and experimental treatment options for children with progressive or recurrent cerebellar low-grade astrocytomas. Dana-Farber/Boston Children’s has a robust research effort aimed at advancing the treatment of brain tumors and improving the lives of brain tumor survivors.
Resources & support
There are also a number of resources and support services at Dana-Farber/Children's Hospital Cancer 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.
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/Children's Hospital Cancer Care established the Stop & Shop Family Pediatric Neuro-Oncology Outcomes Clinic.
Today, more than 1,000 pediatric brain tumor survivors of all ages are followed by the Outcomes Clinic, a multi-disciplinary 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, vision monitoring
- 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 patients and families.