Brainstem Glioma

Surgery alone can often cure grade 1 brainstem gliomas. If surgery cannot remove most of the visible tumor, radiation therapy is very effective.

Unfortunately, the majority of brainstem gliomas are rapidly growing grade 3 or grade 4 astrocytoma, and even grade 2 tumors grow quickly. Because the tumor grows directly in the brainstem, in an area called the pons, surgery to remove the tumor is not possible. This area of the brain controls many vital functions necessary for survival, including breathing, heart rate and blood pressure.

At the same time, if the tumor continues to grow, those functions can be affected by the tumor itself. For this reason, treatment is started as quickly as possible. If the treatment does not control tumor growth, problems with breathing, heart rate, blood pressure and other neurologic deficits will eventually develop.

The most effective and most common initial treatment is radiation therapy. This typically is done over a six-week period. In some cases doctors may add various forms of chemotherapy, either during or after the radiation, or both. If chemotherapy is given, it is continued for as long as it works to control tumor growth. Tumor regrowth is typically treated with chemotherapy, using either standard or experimental drugs.

In the U.S., most patients have the option to participate in a clinical research study, both for newly diagnosed brainstem glioma and for brainstem glioma that grows despite initial therapy. Most research studies include new experimental drugs.

In many cases, initial treatment will control tumor growth, often for many months. Unfortunately, these tumors tend to grow back in less than one year. Treatment for tumor regrowth is less effective than the initial treatment, and may control tumor growth for only a few months or not at all.

Reviewed by health care specialists at UCSF Benioff Children's Hospital.

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