What are low-grade gliomas?
Low-grade gliomas are brain tumors that originate from glial cells, which support and nourish neurons in the brain. Glial tumors, or gliomas, are divided into four grades, depending on their cells' appearance under a microscope. Grade 1 and 2 gliomas are considered low-grade and account for about two-thirds of all pediatric tumors.
In addition to their grade, low-grade gliomas are also classified based on their location and by the kind of glial cell – astrocytes, oligodendrocytes or ependymocytes – from which they arise. Most low-grade gliomas are both highly treatable and highly curable. The most common kind of low-grade glioma, called a pilocytic astrocytoma, has a cure rate over 90 percent.
What are the symptoms of low-grade gliomas?
Low-grade gliomas are slow-growing tumors. As they grow, they press on surrounding healthy parts of the brain, affecting their function. As such, the symptoms of a pediatric low-grade glioma depend on the tumor's size and where in the brain it is located. Some of the most common symptoms of a pediatric low-grade glioma may include:
- headache, particularly in the morning
- 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
- weight gain or loss
- premature puberty
How we care for low-grade gliomas
Children and adolescents with glioma 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. The Glioma Program also offers families the chance to have their child's tumor molecularly profiled (as long as a biopsy can be taken), which may help identify opportunities for targeted treatment.
What is the long-term outlook for children with gliomas?
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, low-grade gliomas tend to be readily treatable. Prompt medical attention and appropriate therapy are important for the best prognosis.
Low-Grade Gliomas | Diagnosis & Treatments
How are low-grade gliomas diagnosed?
To diagnose a low-grade glioma, 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
After all tests are completed, doctors will be able to outline the best treatment options.
What are the treatment options for low-grade gliomas?
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:
- radiation therapy
We also offer innovative brain tumor clinical trials for children with low-grade gliomas. 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 Pacific Pediatric Neuro-Oncology Consortium (PNOC).
What long-term care will my child need?
Many brain tumor survivors 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 established the Stop & Shop Family Pediatric Neuro-Oncology Outcomes Clinic. This multi-disciplinary program addresses long-term health and social issues for families and survivors of childhood brain tumors.
The Outcomes Clinic follows more than 1,000 pediatric brain tumor survivors of all ages, providing such services as:
- MRI scans to monitor for tumor recurrences
- intellectual function evaluation
- endocrine evaluation and treatment
- neurologic assessment
- psychosocial care
- hearing, 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. Several programs address these needs, among them 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, Outcomes Clinic specialists conduct innovative survivorship research and provide continuing education for staff, patients and families.