Treatment Options for Childhood Astrocytomas

Childhood Low-Grade Astrocytomas
Recurrent Childhood Low-Grade Astrocytomas
Childhood High-Grade Astrocytomas
Recurrent Childhood High-Grade Astrocytomas

A link to a list of current clinical trials is included for each treatment section. For some types or stages of cancer, there may not be any trials listed. Check with your child's doctor for clinical trials that are not listed here but may be right for your child.

When the tumor is first diagnosed, treatment for childhood low-grade astrocytoma depends on the location of the tumor and is usually surgery. An MRI is done after surgery to see if there is tumor remaining.

If the tumor was completely removed by surgery, more treatment may not be needed and the child is closely watched to see if symptoms appear or change. This is also called watchful waiting.

If there is tumor remaining after surgery, treatment may include the following:

• Watchful waiting.
• More surgery to remove the tumor.
• Cerebrospinal fluid diversion.
• Radiation therapy, which may include conformal radiation therapy or stereotactic radiation therapy.
• Combination chemotherapy with or without radiation therapy.
• A clinical trial of a new treatment.

In some cases, children who have a visual pathway glioma will be treated by watchful waiting. In other cases, treatment may include surgery or radiation therapy. A goal of treatment is to save as much vision as possible. The effect of tumor growth on the child's vision will be closely followed during treatment.

Children with neurofibromatosis type 1 (NF1) may not need treatment unless the tumor grows or symptoms, such as vision problems, appear.

Children with tuberous sclerosis may develop benign (not cancer) tumors in the brain called subependymal giant cell astrocytomas (SEGAs). These tumors may be treated with drugs to shrink them instead of surgery.

Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with childhood low-grade untreated astrocytoma or other tumor of glial origin. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.

Before more cancer treatment is given, imaging tests, biopsy, or surgery are done to be sure cancer is present and find out how much cancer there is.

Treatment of recurrent childhood low-grade astrocytoma may include the following:

• More surgery to remove the tumor.
• Radiation therapy to the tumor only, if radiation therapy was not used when the tumor was first diagnosed. Conformal radiation therapy may be given.
• Surgery, chemotherapy, and/or radiation therapy, if the patient had only surgery when the tumor was first diagnosed.
• Chemotherapy if the tumor recurred after treatment with radiation therapy.
• Chemotherapy if the tumor recurred where it cannot be removed by surgery and the patient had radiation therapy when the tumor was first diagnosed.
• A clinical trial of a new treatment.

Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with recurrent childhood astrocytoma or other tumor of glial origin. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.

Treatment of childhood high-grade astrocytoma may include the following:

• Surgery, chemotherapy, and radiation therapy to the tumor.
• A clinical trial of chemotherapy with or without radiation therapy.
• A clinical trial of targeted therapy with a monoclonal antibody or chemotherapy given at the same time as radiation therapy to the tumor, followed by more treatment with targeted therapy and chemotherapy.

Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with childhood high-grade untreated astrocytoma or other tumor of glial origin. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.

Treatment of recurrent childhood high-grade astrocytoma may include the following:

• Surgery.
• High-dose chemotherapy with stem cell transplant.
• A clinical trial of a new treatment.

Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with recurrent childhood astrocytoma or other tumor of glial origin. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.