Astrocytoma

An astrocytoma is a brain tumor that originates from star-shaped cells called astrocytes. Astrocytes are a kind of glial cell, cells that support and nourish neurons in the brain. Like other kinds of gliomas (tumors that arise from glial cells), astrocytomas are divided into four grades, depending on their cells' appearance under a microscope; the higher a tumor's grade number, the more severe it is. Grades 1 and 2 are considered low-grade astrocytomas, and grades 3 and 4 are considered high-grade astrocytomas.

Most astrocytomas are both highly treatable and highly curable. The most common kind of astrocytoma, called a pilocytic astrocytoma, has a cure rate over 90 percent.

As an astrocytoma grows, it presses on surrounding healthy parts of the brain, affecting their function. Because of this, the symptoms of a pediatric astrocytoma depend on the tumor's size and where in the brain it is located.

Some of the most common symptoms of a pediatric astrocytoma include:

• Headache, particularly in the morning or made better by vomiting
• Severe or frequent vomiting without other signs of gastrointestinal illness
• Vision problems, such as double vision, blurry vision or loss of vision
• Difficulty walking or balancing
• Seizures
• Weight gain or loss
• Premature puberty
• Clumsiness
• Confusion
• Sleepiness
• Changes in behavior

The exact cause of most astrocytomas is not known, but certain factors, such as genetic and immunologic abnormalities, environmental factors, diet or stress may contribute.

To diagnose a pediatric astrocytoma, your doctor will take your child's medical history and carry out both physical and neurological exams. Your doctor may also order a variety of tests, including:

• Magnetic resonance imaging (MRI)
• Biopsy or tissue sample
• Electroencephalogram (EEG)
• Lumbar puncture

Specific astrocytoma diagnoses could include:

• Pilocytic astrocytoma
• Fibrillary astrocytoma
• Anaplastic astrocytoma
• Gliomatosis cerebri
• Gliosarcoma
• Dysembryoplastic neuroepithelial tumor (DNET or DNT)
• Ganglioglioma and glial neuronal tumors
• Optic nerve (pathway) glioma
• Pleomorphic xanthoastrocytoma (PXA)
• Brainstem tumors, including diffuse pontine glioma (DIPG) and tectal glioma
• Thalamic and hypothalamic astrocytoma

After all tests are completed, doctors will be able to outline the best treatment options.

Our treatment approach for pediatric gliomas is personalized for each patient depending on several factors, including the tumor's type, stage and location. Some therapies will treat the tumor, while others are intended to address complications of the disease or side effects of the treatment.

In addition, our clinicians may offer access to targeted treatments based on the molecular profile of your child's tumor.

Some of the options your doctor may discuss include:

• Surgery to remove as much of the tumor as possible
• Chemotherapy
• Radiation therapy

We also offer innovative brain tumor clinical trials for children with astrocytomas. Some of these were launched by our own physicians, while others are available through our participation in collaborative groups such as the Children's Oncology Group (COG) and the Pediatric Oncology Experimental Therapeutics Investigators' Consortium (POETIC).

Should you have questions or need advice on whether a particular trial would be appropriate for your child, email our clinical trials team at clinicaltrials@danafarberbostonchildrens.org.

Your child’s prognosis (chance of recovery) and treatment options depend on a number of different factors, including:

• Type of tumor
• Tumor grade
• The extent of the disease
• The size and location of the tumor
• The presence or absence of metastasis
• The tumor's response to therapy
• The age and overall health of your child
• Your child's tolerance of specific medications, procedures or therapies
• New developments in treatment

In general, astrocytomas tend to be readily treatable. Prompt medical attention and appropriate therapy are important for the best prognosis.

Children and adolescents with astrocytomas are treated at Dana-Farber/Boston Children's Cancer and Blood Disorders Center through the Brain Tumor Center's Glioma Program, one of the largest and most experienced pediatric glioma programs in the world. Our glioma specialists — a team of neuro-oncologists, surgeons, pathologists and radiation oncologists — focus solely on the care of children diagnosed with gliomas.

At Dana-Farber/Boston Children's our physicians work continuously to translate laboratory findings into clinical therapies and find ways to improve survival, while reducing the toxicity and long-term impact of treatment. The Glioma Program's research enterprise mirrors its clinical efforts in its multidisciplinary nature. Basic, translational and clinical scientists in the program work together and with colleagues at institutions like the Broad Institute to uncover new knowledge about the biology of gliomas and translate that understanding into new therapies or ways of overcoming resistance to existing ones.

Dana-Farber/Boston Children's is also home to the Pediatric Low-grade Astrocytoma (PLGA) Program, the world's only multidisciplinary clinical and research program dedicated to pediatric low-grade gliomas. Established in 2007 with support from the PLGA Foundation, the program takes a multifaceted approach to finding more effective, less toxic treatments and a cure for children battling brain tumors, and has become the standard bearer for the research and care of pediatric brain tumors.