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<div class="pre-content"><div><div class="bk_prnt"><p class="small">NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.</p><p>PDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute (US); 2002-. </p></div><div class="iconblock clearfix whole_rhythm no_top_margin bk_noprnt"><a class="img_link icnblk_img" title="Table of Contents Page" href="/books/n/pdqcis/"><img class="source-thumb" src="/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-pdqcis-lrg.png" alt="Cover of PDQ Cancer Information Summaries" height="100px" width="80px" /></a><div class="icnblk_cntnt eight_col"><h2>PDQ Cancer Information Summaries [Internet].</h2><a data-jig="ncbitoggler" href="#__NBK65954_dtls__">Show details</a><div style="display:none" class="ui-widget" id="__NBK65954_dtls__"><div>Bethesda (MD): <a href="http://www.cancer.gov/" ref="pagearea=page-banner&targetsite=external&targetcat=link&targettype=publisher">National Cancer Institute (US)</a>; 2002-.</div></div><div class="half_rhythm"></div><div class="bk_noprnt"><form method="get" action="/books/n/pdqcis/" id="bk_srch"><div class="bk_search"><label for="bk_term" class="offscreen_noflow">Search term</label><input type="text" title="Search this book" id="bk_term" name="term" value="" data-jig="ncbiclearbutton" /> <input type="submit" class="jig-ncbibutton" value="Search this book" submit="false" style="padding: 0.1em 0.4em;" /></div></form></div></div></div></div></div>
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<div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/CreativeWork"><div class="meta-content fm-sec"><h1 id="_NBK65954_"><span class="title" itemprop="name">Childhood Astrocytomas Treatment (PDQ®)</span></h1><div class="subtitle whole_rhythm">Patient Version</div><p class="contrib-group"><span itemprop="author">PDQ Pediatric Treatment Editorial Board</span>.</p><p class="small">Published online: August 26, 2015.</p><p class="small">Created: <span itemprop="datePublished">February 5, 2010</span>.</p></div><div class="jig-ncbiinpagenav body-content whole_rhythm" data-jigconfig="allHeadingLevels: ['h2'],smoothScroll: false" itemprop="text"><div id="_abs_rndgid_" itemprop="description"><p id="CDR0000574295__269">This PDQ cancer information summary has current information about the treatment of childhood astrocytomas. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.</p><p id="CDR0000574295__270">Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Date Last Modified") is the date of the most recent change. The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Pediatric Treatment Editorial Board.</p></div><div id="CDR0000574295__1"><h2 id="_CDR0000574295__1_">General Information About Childhood Astrocytomas</h2><div class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000574295__2">Childhood astrocytoma is a disease in which benign (noncancer) or malignant (cancer) cells form in the tissues of the brain. </a></div></li><li class="half_rhythm"><div><a href="#CDR0000574295__238">Astrocytomas may be benign (not cancer) or malignant (cancer).</a></div></li><li class="half_rhythm"><div><a href="#CDR0000574295__171">The central nervous system controls many important body functions.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000574295__9">The cause of most childhood brain tumors is not known. </a></div></li><li class="half_rhythm"><div><a href="#CDR0000574295__12">The signs and symptoms of astrocytomas are not the same in every child. </a></div></li><li class="half_rhythm"><div><a href="#CDR0000574295__16">Tests that examine the brain and spinal cord are used to detect (find) childhood astrocytomas. </a></div></li><li class="half_rhythm"><div><a href="#CDR0000574295__94">Childhood astrocytomas are usually diagnosed and removed in surgery.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000574295__20">Certain factors affect prognosis (chance of recovery) and treatment options.</a></div></li></ul></div><div id="CDR0000574295__2"><h3>Childhood astrocytoma is a disease in which benign (noncancer) or malignant (cancer) cells form in the tissues of the brain. </h3><p id="CDR0000574295__4"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045602/" class="def">Astrocytomas</a> are <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumors</a> that start in star-shaped brain <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a> called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000269436/" class="def">astrocytes</a>. An astrocyte is a type of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000269440/" class="def">glial cell</a>. Glial cells hold <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000269443/" class="def">nerve cells</a> in place, bring food and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000538149/" class="def">oxygen</a> to them, and help protect them from disease, such as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045364/" class="def">infection</a>. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045700/" class="def">Gliomas</a> are tumors that form from glial cells. An astrocytoma is a type of glioma.</p><p id="CDR0000574295__235">Astrocytoma is the most common type of glioma <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046450/" class="def">diagnosed</a> in children. It can form anywhere in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046481/" class="def">central nervous system</a> (brain and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000340937/" class="def">spinal cord</a>). </p><p id="CDR0000574295__194">This summary is about the treatment of tumors that begin in astrocytes in the brain (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045847/" class="def">primary</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000387264/" class="def">brain tumors</a>). <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044058/" class="def">Metastatic</a> brain tumors are formed by <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> cells that begin in other parts of the body and spread to the brain.
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Treatment of metastatic brain tumors is not discussed here. </p><p id="CDR0000574295__8">Brain tumors can occur in both children and adults. However, treatment for children may be different than treatment for adults. See the following <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044271/" class="def">PDQ</a> summaries for more information about other types of brain tumors in children and adults:
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</p><ul id="CDR0000574295__266"><li class="half_rhythm"><div><a href="/books/n/pdqcis/CDR0000257997/">Childhood Brain and Spinal Cord Tumors Treatment Overview</a></div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/CDR0000062697/">Adult Central Nervous System Tumors Treatment</a></div></li></ul></div><div id="CDR0000574295__238"><h3>Astrocytomas may be benign (not cancer) or malignant (cancer).</h3><p id="CDR0000574295__240"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045614/" class="def">Benign</a> brain tumors grow and press on nearby areas of the brain. They rarely spread into other <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissues</a>. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045772/" class="def">Malignant</a> brain tumors are likely to grow quickly and spread into other brain tissue. When a tumor grows into or presses on an area of the brain, it may stop that part of the brain from working the way it should. Both benign and malignant brain tumors can cause <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000750109/" class="def">signs</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a> and almost all need treatment.</p></div><div id="CDR0000574295__171"><h3>The central nervous system controls many important body functions.</h3><p id="CDR0000574295__161">Astrocytomas are most common in these parts of the central nervous system (CNS):</p><ul id="CDR0000574295__5"><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046484/" class="def">Cerebrum</a></b>: The largest part of the brain, at the top of the head. The cerebrum controls thinking, learning, problem-solving, speech, emotions, reading, writing, and voluntary movement.
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</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046714/" class="def">Cerebellum</a></b>: The lower, back part of the brain (near the middle of the back of the head). The cerebellum controls movement, balance, and posture.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046491/" class="def">Brain stem</a></b>: The part that connects the brain to the spinal cord, in the lowest part of the brain (just above the back of the neck). The brain stem controls breathing, heart rate, and the nerves and muscles used in seeing, hearing, walking, talking, and eating. </div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046359/" class="def">Hypothalamus</a></b>: The area in the middle of the base of the brain that controls body
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temperature, hunger, and thirst.</div></li><li class="half_rhythm"><div><b>Visual pathway</b>: The group of nerves that connect the eye with the brain.</div></li><li class="half_rhythm"><div><b>Spinal cord</b>: The column of nerve tissue that runs from the brain stem down the center of the back. It is covered by three thin layers of tissue called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046294/" class="def">membranes</a>. The spinal cord and membranes are surrounded by the vertebrae (back bones). Spinal cord nerves carry messages between the brain and the rest of the body, such as a message from the brain to cause muscles to move or a message from the skin to the brain to feel touch.</div></li></ul><div class="iconblock whole_rhythm clearfix ten_col fig" id="figCDR0000574295268" co-legend-rid="figlgndCDR0000574295268"><a href="/books/NBK65954.1/figure/CDR0000574295__268/?report=objectonly" target="object" title="Figure" class="img_link icnblk_img figpopup" rid-figpopup="figCDR0000574295268" rid-ob="figobCDR0000574295268"><img class="small-thumb" src="/books/NBK65954.1/bin/CDR0000772103.gif" src-large="/books/NBK65954.1/bin/CDR0000772103.jpg" alt="Anatomy of the brain showing the cerebrum, ventricles (with cerebrospinal fluid shown in blue), cerebellum, brain stem (pons and medulla), and other parts of the brain" /></a><div class="icnblk_cntnt" id="figlgndCDR0000574295268"><h4 id="CDR0000574295__268"><a href="/books/NBK65954.1/figure/CDR0000574295__268/?report=objectonly" target="object" rid-ob="figobCDR0000574295268">Figure</a></h4><p class="float-caption no_bottom_margin">Anatomy of the brain showing the cerebrum, ventricles (with cerebrospinal fluid shown in blue), cerebellum, brain stem (pons and medulla), and other parts of the brain. </p></div></div></div><div id="CDR0000574295__9"><h3>The cause of most childhood brain tumors is not known. </h3><p id="CDR0000574295__11">Anything that increases your risk of getting a disease is called a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045873/" class="def">risk factor</a>. Having a risk factor does not mean that you will get cancer; not having risk factors doesn’t mean that you will not get cancer. Talk with your child's doctor if you think your child may be at risk. Possible risk factors for astrocytoma include: </p><ul id="CDR0000574295__185"><li class="half_rhythm"><div>Past <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">radiation therapy</a> to the brain.</div></li><li class="half_rhythm"><div>Having certain <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046391/" class="def">genetic</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000407758/" class="def">disorders</a>, such as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045096/" class="def">neurofibromatosis type 1</a> (NF1) or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000304692/" class="def">tuberous sclerosis</a>.</div></li></ul><p id="CDR0000574295__128">Having NF1 may increase a child's risk of a certain type of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046137/" class="def">visual pathway glioma</a>. These tumors usually do not cause symptoms. Children with NF1 who develop visual pathway gliomas may not need treatment for the tumor unless signs or symptoms, such as vision problems, appear or the tumor grows.
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</p></div><div id="CDR0000574295__12"><h3>The signs and symptoms of astrocytomas are not the same in every child. </h3><p id="CDR0000574295__14">Signs and symptoms depend on the following: </p><ul id="CDR0000574295__191"><li class="half_rhythm"><div>Where the tumor forms in the brain or spinal cord.</div></li><li class="half_rhythm"><div>The size of the tumor.</div></li><li class="half_rhythm"><div>How fast the tumor grows.</div></li><li class="half_rhythm"><div>The child's age and development.</div></li></ul><p id="CDR0000574295__192">Some tumors do not cause signs or symptoms. Signs and symptoms may be caused by childhood astrocytomas or by other conditions. Check with your child's doctor if your child has any of the following:</p><ul id="CDR0000574295__15"><li class="half_rhythm"><div>Morning headache or headache that goes away after <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000390324/" class="def">vomiting</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000390302/" class="def">Nausea</a> and vomiting.</div></li><li class="half_rhythm"><div>Vision, hearing, and speech problems.
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</div></li><li class="half_rhythm"><div>Loss of balance and trouble walking.
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</div></li><li class="half_rhythm"><div>Worsening handwriting or slow speech.</div></li><li class="half_rhythm"><div>Weakness or change in feeling on one side of the body.</div></li><li class="half_rhythm"><div>Unusual sleepiness.</div></li><li class="half_rhythm"><div>More or less energy than usual.</div></li><li class="half_rhythm"><div>Change in personality or behavior.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045484/" class="def">Seizures</a>.</div></li><li class="half_rhythm"><div>Weight loss or weight gain for no known reason.
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</div></li><li class="half_rhythm"><div>Increase in the size of the head (in infants).
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</div></li></ul></div><div id="CDR0000574295__16"><h3>Tests that examine the brain and spinal cord are used to detect (find) childhood astrocytomas. </h3><p id="CDR0000574295__18">The following tests and procedures may be used:</p><ul id="CDR0000574295__19"><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270871/" class="def">Physical exam</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000689078/" class="def">history</a></b>: An exam of the body to check general <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000750109/" class="def">signs</a> of health. This includes checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
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</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000322871/" class="def">Neurological exam</a></b>: A series of questions and tests to check the brain, spinal cord, and nerve function. The exam checks a person’s mental status, coordination, and ability to walk normally, and how well the muscles, senses, and reflexes work. This may also be called a neuro exam or a neurologic exam.
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</div></li><li class="half_rhythm"><div><b>Visual field exam</b>: An exam to check a person’s field of vision (the total area in which objects can be seen). This test measures both central vision (how much a person can see when looking straight ahead) and peripheral vision (how much a person can see in all other directions while staring straight ahead). The eyes are tested one at a time. The eye not being tested is covered.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045788/" class="def">MRI</a> (magnetic resonance imaging) with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000597153/" class="def">gadolinium</a></b>: A procedure that uses a magnet, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651209/" class="def">radio waves</a>, and a computer to make a series of detailed pictures of the brain and spinal cord. A substance called gadolinium is <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044678/" class="def">injected</a> into a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000476471/" class="def">vein</a>. The gadolinium collects around the cancer cells so they show up brighter in the picture. This procedure is also called nuclear magnetic resonance imaging (NMRI). Sometimes <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000269422/" class="def">magnetic resonance spectroscopy</a> (MRS) is done during the same MRI scan to look at the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000643008/" class="def">chemical</a> makeup of the brain tissue. </div></li></ul></div><div id="CDR0000574295__94"><h3>Childhood astrocytomas are usually diagnosed and removed in surgery.</h3><p id="CDR0000574295__96">If doctors think there may be an astrocytoma, a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045164/" class="def">biopsy</a> may be done to remove a sample of tissue.
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For tumors in the brain, a part of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000763008/" class="def">skull</a> is removed and a needle is used to remove tissue. Sometimes, the needle is guided by a computer. A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046244/" class="def">pathologist</a> views the tissue under a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000638184/" class="def">microscope</a> to look for cancer cells. If cancer cells are found, the doctor may remove as much tumor as safely possible during the same <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">surgery</a>. Because it can be hard to tell the difference between types of brain tumors, you may want to have your child's tissue sample checked by a pathologist who has experience in <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046450/" class="def">diagnosing</a> brain tumors. </p><div class="iconblock whole_rhythm clearfix ten_col fig" id="figCDR0000574295230" co-legend-rid="figlgndCDR0000574295230"><a href="/books/NBK65954.1/figure/CDR0000574295__230/?report=objectonly" target="object" title="Figure" class="img_link icnblk_img figpopup" rid-figpopup="figCDR0000574295230" rid-ob="figobCDR0000574295230"><img class="small-thumb" src="/books/NBK65954.1/bin/CDR0000691155.gif" src-large="/books/NBK65954.1/bin/CDR0000691155.jpg" alt="Craniotomy: An opening is made in the skull and a piece of the skull is removed to show part of the brain" /></a><div class="icnblk_cntnt" id="figlgndCDR0000574295230"><h4 id="CDR0000574295__230"><a href="/books/NBK65954.1/figure/CDR0000574295__230/?report=objectonly" target="object" rid-ob="figobCDR0000574295230">Figure</a></h4><p class="float-caption no_bottom_margin">Craniotomy: An opening is made in the skull and a piece of the skull is removed to show part of the brain. </p></div></div><p id="CDR0000574295__123">The following test may be done on the tissue that was removed:</p><ul id="CDR0000574295__124"><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000653117/" class="def">Immunohistochemistry</a></b>: A test that uses <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044918/" class="def">antibodies</a> to check for certain <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046086/" class="def">antigens</a> in a sample of tissue. The antibody is usually linked to a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046550/" class="def">radioactive</a> substance or a dye that causes the tissue to light up under a microscope. This type of test may be used to tell the difference between different types of cancer. An MIB-1 test is a type of immunohistochemistry that checks tumor tissue for an antigen called MIB-1. This may show how fast a tumor is growing.</div></li></ul><p id="CDR0000574295__241">Sometimes tumors form in a place that makes them hard to remove. If removing the tumor may cause severe physical, emotional, or learning problems, a biopsy is done and more treatment is given after the biopsy.</p><p id="CDR0000574295__129">Children who have NF1 may not need a biopsy or surgery to remove the tumor.</p></div><div id="CDR0000574295__20"><h3>Certain factors affect prognosis (chance of recovery) and treatment options.</h3><p id="CDR0000574295__164">The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045849/" class="def">prognosis</a> (chance of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000454708/" class="def">recovery</a>) and treatment options depend on the following:</p><ul id="CDR0000574295__165"><li class="half_rhythm"><div>Where the astrocytoma formed in the CNS and if it has spread.</div></li><li class="half_rhythm"><div>Whether cancer cells remain after surgery.</div></li><li class="half_rhythm"><div>The type and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045702/" class="def">grade</a> of astrocytoma.
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</div></li><li class="half_rhythm"><div>Whether the child has NF1.</div></li><li class="half_rhythm"><div>Whether there are certain changes in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045693/" class="def">genes</a>.</div></li><li class="half_rhythm"><div>The child’s age.
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</div></li><li class="half_rhythm"><div>Whether the astrocytoma has just been diagnosed or has <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046556/" class="def">recurred</a> (come back).
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</div></li></ul><p id="CDR0000574295__190">For <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045862/" class="def">recurrent</a> astrocytoma, prognosis and treatment depend on how much time passed from the time treatment ended to the time the astrocytoma recurred.</p></div></div><div id="CDR0000574295__26"><h2 id="_CDR0000574295__26_">Stages of Childhood Astrocytomas</h2><div class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000574295__27">The grade of the tumor is used to plan cancer treatment.
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</a></div></li><li class="half_rhythm"><div><a href="#CDR0000574295__174">An MRI is done after surgery. </a></div></li></ul></div><div id="CDR0000574295__27"><h3>The grade of the tumor is used to plan cancer treatment.
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</h3><p id="CDR0000574295__29"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046597/" class="def">Staging</a> is the process used to find out how much <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> there is and if cancer has spread. It is important to know the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045885/" class="def">stage</a> in order to plan treatment.
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</p><p id="CDR0000574295__130">There is no standard <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000689095/" class="def">staging system</a> for childhood <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045602/" class="def">astrocytoma</a>. Treatment is based on the following:
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</p><ul id="CDR0000574295__242"><li class="half_rhythm"><div>The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045702/" class="def">grade</a> of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a>.</div></li><li class="half_rhythm"><div>Whether the tumor is newly <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046450/" class="def">diagnosed</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045862/" class="def">recurrent</a> (has come back after treatment).</div></li></ul><p id="CDR0000574295__243">The grade of the tumor describes how <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044636/" class="def">abnormal</a> the cancer <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a> look under a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000638184/" class="def">microscope</a> and how quickly the tumor is likely to grow and spread.</p><p id="CDR0000574295__97">The following grades are used:</p><div id="CDR0000574295__131"><h4>Low-grade astrocytomas</h4><p id="CDR0000574295__133"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000386213/" class="def">Low-grade</a> astrocytomas are slow-growing and rarely spread to other parts of the brain and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000340937/" class="def">spinal cord</a> or other parts of the body. Low-grade astrocytomas can be either:</p><ul id="CDR0000574295__263"><li class="half_rhythm"><div>Grade I tumors–<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044341/" class="def">pilocytic</a> tumors, with cells that form a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046461/" class="def">cyst</a>.</div></li><li class="half_rhythm"><div>Grade II tumors–fibrillary tumors, with cells that look long or like <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046401/" class="def">fibers</a>. </div></li></ul><p id="CDR0000574295__244">There are many types of low-grade astrocytomas. Several types of low-grade astrocytomas are discussed in this summary:</p><ul id="CDR0000574295__262"><li class="half_rhythm"><div>A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046137/" class="def">visual pathway glioma</a> is a type of low-grade astrocytoma that forms along the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046248/" class="def">optic nerve</a> pathway.</div></li><li class="half_rhythm"><div>A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000689357/" class="def">subependymal giant cell astrocytoma</a> is a type of low-grade astrocytoma that may occur in children with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000304692/" class="def">tuberous sclerosis</a>.</div></li></ul><p id="CDR0000574295__264">Children who have <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045096/" class="def">neurofibromatosis type 1</a> may have more than one low-grade tumor in the brain.</p></div><div id="CDR0000574295__134"><h4>High-grade astrocytomas</h4><p id="CDR0000574295__136">
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000386205/" class="def">High-grade</a> astrocytomas are fast-growing and often spread within the brain and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000340937/" class="def">spinal cord</a>. High grade astrocytomas can be either:</p><ul id="CDR0000574295__265"><li class="half_rhythm"><div>Grade III tumors–<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045591/" class="def">anaplastic</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045772/" class="def">malignant</a> tumors. </div></li><li class="half_rhythm"><div>Grade IV tumors–<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045698/" class="def">glioblastoma</a>, which spreads the fastest. </div></li></ul><p id="CDR0000574295__99">Childhood astrocytomas usually do not spread to other parts of the body.
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</p></div></div><div id="CDR0000574295__174"><h3>An MRI is done after surgery. </h3><p id="CDR0000574295__173">An <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045788/" class="def">MRI</a> (magnetic resonance imaging) is done in the first few days after <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">surgery</a>. This is to find out how much tumor, if any, remains after surgery and to plan further treatment.</p></div></div><div id="CDR0000574295__31"><h2 id="_CDR0000574295__31_">Recurrent Childhood Astrocytomas</h2><p id="CDR0000574295__32">A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045862/" class="def">recurrent</a> childhood <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045602/" class="def">astrocytoma</a> is an astrocytoma that has <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046556/" class="def">recurred</a> (come back) after it has been treated. The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> may come back in the same place as the first <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> or in other parts of the body. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000386205/" class="def">High-grade</a> astrocytomas often recur within 3 years.</p></div><div id="CDR0000574295__33"><h2 id="_CDR0000574295__33_">Treatment Option Overview</h2><div class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000574295__34">There are different types of treatment for patients with childhood astrocytoma.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000574295__38">Children with astrocytomas should have their treatment planned by a team of health care providers who are experts in treating childhood brain tumors.
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</a></div></li><li class="half_rhythm"><div><a href="#CDR0000574295__125">Childhood brain tumors may cause signs or symptoms that begin before the cancer is diagnosed and continue for months or years. </a></div></li><li class="half_rhythm"><div><a href="#CDR0000574295__42">Some cancer treatments cause side effects months or years after treatment has ended. </a></div></li><li class="half_rhythm"><div><a href="#CDR0000574295__45">Six types of treatment are used:</a></div></li><li class="half_rhythm"><div><a href="#CDR0000574295__216"> New types of treatment are being tested in clinical trials.
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</a></div></li><li class="half_rhythm"><div><a href="#CDR0000574295__257">If fluid builds up around the brain and spinal cord, a cerebrospinal fluid diversion procedure may be done.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000574295__117">Patients may want to think about taking part in a clinical trial.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000574295__119">Patients can enter clinical trials before, during, or after starting their cancer treatment.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000574295__121">Follow-up tests may be needed.</a></div></li></ul></div><div id="CDR0000574295__34"><h3>There are different types of treatment for patients with childhood astrocytoma.</h3><p id="CDR0000574295__36">Different types of treatment are available for children with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045602/" class="def">astrocytomas</a>. Some treatments are <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044930/" class="def">standard</a> (the currently used treatment), and some are being tested in <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trials</a>. A treatment clinical trial is a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651211/" class="def">research study</a> meant to help improve current treatments or obtain information on new treatments for patients with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a>. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment.
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</p><p id="CDR0000574295__37">Because cancer in children is rare, taking part in a clinical trial should be considered. Some clinical trials are open only to patients who have not started treatment.</p></div><div id="CDR0000574295__38"><h3>Children with astrocytomas should have their treatment planned by a team of health care providers who are experts in treating childhood brain tumors.
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</h3><p id="CDR0000574295__166">Treatment will be overseen by a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000693555/" class="def">pediatric oncologist</a>, a doctor who specializes in treating children with cancer. The pediatric oncologist works with other <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000650566/" class="def">healthcare providers</a> who are experts in treating children with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000387264/" class="def">brain tumors</a> and who specialize in certain areas of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000482419/" class="def">medicine</a>. These may include the following <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000478785/" class="def">specialists</a>:</p><ul id="CDR0000574295__41"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000757278/" class="def">Pediatrician</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046245/" class="def">Pediatric</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046269/" class="def">neurosurgeon</a>.
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</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046267/" class="def">Neurologist</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000318818/" class="def">Neuropathologist</a>.
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</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000318819/" class="def">Neuroradiologist</a>.
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</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000318825/" class="def">Rehabilitation specialist</a>.
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</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046546/" class="def">Radiation oncologist</a>.
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</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046439/" class="def">Endocrinologist</a>.
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</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044716/" class="def">Psychologist</a>.
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</div></li></ul></div><div id="CDR0000574295__125"><h3>Childhood brain tumors may cause signs or symptoms that begin before the cancer is diagnosed and continue for months or years. </h3><p id="CDR0000574295__127"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000750109/" class="def">Signs</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a> caused by the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> may begin before <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046450/" class="def">diagnosis</a>. These signs or symptoms may continue for months or years. It is important to talk with your child's doctors about signs or symptoms caused by the tumor that may continue after treatment. </p></div><div id="CDR0000574295__42"><h3>Some cancer treatments cause side effects months or years after treatment has ended. </h3><p id="CDR0000574295__44"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046580/" class="def">Side effects</a> from cancer treatment that begin during or after treatment and continue for months or years are called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000390292/" class="def">late effects</a>. Late effects of cancer treatment may include the following:</p><ul id="CDR0000574295__92"><li class="half_rhythm"><div>Physical problems.
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</div></li><li class="half_rhythm"><div>Changes in mood, feelings, thinking, learning, or memory.
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</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046658/" class="def">Second cancers</a> (new types of cancer).
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</div></li></ul><p id="CDR0000574295__93">Some late effects may be treated or controlled. It is important to talk with your child's doctors about the effects cancer treatment can have on your child. (See the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044271/" class="def">PDQ</a> summary on <a href="/books/n/pdqcis/CDR0000373791/">Late Effects of Treatment for Childhood Cancer</a> for more information.)</p></div><div id="CDR0000574295__45"><h3>Six types of treatment are used:</h3><div id="CDR0000574295__47"><h4>Surgery</h4><p id="CDR0000574295__49"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">Surgery</a> is used to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046450/" class="def">diagnose</a> and treat childhood astrocytoma as discussed in the <a href="#CDR0000574295__94">General Information</a> section of this summary. If cancer <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a> remain after surgery, further treatment depends on: </p><ul id="CDR0000574295__193"><li class="half_rhythm"><div>Where the remaining cancer cells are.</div></li><li class="half_rhythm"><div>The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045702/" class="def">grade</a> of the tumor.</div></li><li class="half_rhythm"><div>The age of the child.</div></li></ul><p id="CDR0000574295__106">Even if the doctor removes all the cancer that can be seen at the time of the surgery, some patients may be given <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">chemotherapy</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">radiation therapy</a> after surgery to kill any cancer cells that remain. Treatment given after the surgery, to lower the risk that the cancer will come back, is called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045587/" class="def">adjuvant therapy</a>.</p></div><div id="CDR0000574295__107"><h4>Observation</h4><p id="CDR0000574295__109"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045981/" class="def">Observation</a> is closely <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000454803/" class="def">monitoring</a> a patient’s <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651193/" class="def">condition</a> without giving any treatment until signs or symptoms appear or change. Observation is often used for patients who have <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045096/" class="def">neurofibromatosis type1</a> or a tumor that is not growing and spreading.</p></div><div id="CDR0000574295__51"><h4>Radiation therapy</h4><p id="CDR0000574295__53">
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Radiation therapy is a cancer treatment that uses high-energy <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045944/" class="def">x-rays</a> or other types of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045072/" class="def">radiation</a> to kill cancer cells or keep them from growing. There are two types of radiation therapy: </p><ul id="CDR0000574295__245"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046686/" class="def">External radiation therapy</a> uses a machine outside the body to send radiation toward the cancer.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046345/" class="def">Internal radiation therapy</a> uses a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046550/" class="def">radioactive</a> substance sealed in needles, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257219/" class="def">seeds</a>, wires, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045637/" class="def">catheters</a> that are placed directly into or near the cancer.</div></li></ul><p id="CDR0000574295__246">External radiation therapy is used to treat astrocytoma in children. The way the radiation therapy is given depends on the type of tumor and where the tumor formed in the brain or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000340937/" class="def">spinal cord</a>.
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</p><p id="CDR0000574295__201">Radiation therapy to the brain can affect growth and development in young children. Certain ways of giving radiation therapy can lessen the damage to healthy brain <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissue</a>:
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</p><ul id="CDR0000574295__202"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270731/" class="def">Conformal radiation therapy</a> uses a computer to make a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045582/" class="def">3-dimensional</a> (3-D) picture of the tumor and shapes the radiation beams to fit the tumor. This allows a high <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044664/" class="def">dose</a> of radiation to reach the tumor and causes less damage to normal tissue around the tumor. </div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000335073/" class="def">Intensity-modulated radiation therapy</a> (IMRT) uses images created by a computer that show the size and shape of the tumor. Thin beams of radiation of different strengths are aimed at the tumor from many angles.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044464/" class="def">Stereotactic radiation therapy</a> uses a rigid head frame attached to the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000763008/" class="def">skull</a> to aim radiation directly to the tumor, causing less damage to normal tissue around the tumor. The total dose of radiation is divided into several smaller doses given over several days. This procedure is also called stereotactic external-beam radiation therapy and stereotaxic radiation therapy. </div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270726/" class="def">Proton beam radiation therapy</a> is a type of high-energy, external radiation therapy that uses streams of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044715/" class="def">protons</a> (small, positively-charged particles of matter) to kill tumor cells.</div></li></ul><p id="CDR0000574295__168">For children younger than 3 years, chemotherapy may be given instead, to delay or reduce the need for radiation therapy.
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</p></div><div id="CDR0000574295__54"><h4>Chemotherapy</h4><p id="CDR0000574295__56">
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Chemotherapy is a cancer treatment that uses <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000348921/" class="def">drugs</a> to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044678/" class="def">injected</a> into a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000476471/" class="def">vein</a> or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000301626/" class="def">systemic chemotherapy</a>). When chemotherapy is placed directly into the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046483/" class="def">cerebrospinal fluid</a>, an <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257523/" class="def">organ</a>, or a body <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000463703/" class="def">cavity</a> such as the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045070/" class="def">abdomen</a>, the drugs mainly affect cancer cells in those areas (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046559/" class="def">regional chemotherapy</a>). <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045650/" class="def">Combination chemotherapy</a> is the use of more than one anticancer drug.
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</p><p id="CDR0000574295__261">Systemic chemotherapy is used in the treatment of children with astrocytoma. The way the chemotherapy is given depends on the type of tumor and where the tumor formed in the brain or spinal cord.</p></div><div id="CDR0000574295__112"><h4>High-dose chemotherapy with stem cell transplant</h4><p id="CDR0000574295__114"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000346522/" class="def">High-dose chemotherapy</a> with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046695/" class="def">stem cell transplant</a> is a way of giving high doses of chemotherapy and replacing <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270735/" class="def">blood</a>-forming cells destroyed by the cancer treatment. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046598/" class="def">Stem cells</a> (immature blood cells) are removed from the blood or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045622/" class="def">bone marrow</a> of the patient or a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000643010/" class="def">donor</a> and are frozen and stored. After the chemotherapy is completed, the stored stem cells are thawed and given back to the patient through an <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045738/" class="def">infusion</a>. These <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045738/" class="def">reinfused</a> stem cells grow into (and restore) the body's blood cells.</p><p id="CDR0000574295__247">For <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000386205/" class="def">high-grade</a> astrocytoma that has come back after treatment, high-dose chemotherapy with stem cell transplant is used if there is only a small amount of tumor.</p></div><div id="CDR0000574295__219"><h4>Targeted therapy</h4><p id="CDR0000574295__221"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270742/" class="def">Targeted therapy</a> is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells without harming normal cells.</p><p id="CDR0000574295__248">There are different types of targeted therapy:</p><ul id="CDR0000574295__249"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000750798/" class="def">Kinase inhibitors</a> stop cells from dividing and may prevent the growth of new <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045020/" class="def">blood vessels</a> that tumors need to grow. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000386203/" class="def">Everolimus</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045513/" class="def">sirolimus</a> are kinase inhibitors used to treat childhood <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000689357/" class="def">subependymal giant cell astrocytomas</a>. </div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046066/" class="def">Monoclonal antibody</a> therapy uses <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044918/" class="def">antibodies</a> made in the laboratory, from a single type of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046356/" class="def">immune system</a> cell, to stop cancer cells. These antibodies can identify substances on cancer cells or normal substances that may help cancer cells grow. The antibodies attach to the substances and kill the cancer cells, block their growth, or keep them from spreading. Monoclonal antibodies are given by infusion into a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000476471/" class="def">vein</a>. They may be used alone or to carry drugs, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046622/" class="def">toxins</a>, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046550/" class="def">radioactive</a> material directly to cancer cells. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046115/" class="def">Bevacizumab</a> is a type of monoclonal antibody being used to treat of childhood astrocytoma. </div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000486603/" class="def">Protein kinase inhibitors</a> block <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046092/" class="def">proteins</a> needed for cell growth and may kill cancer cells. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000761601/" class="def">Selumetinib</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000750069/" class="def">dabrafenib</a> are types of protein kinase inhibitors being studied in the treatment of childhood astrocytoma. </div></li></ul><p id="CDR0000574295__267">See <a href="http://www.cancer.gov/about-cancer/treatment/drugs/brain" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Drugs Approved for Brain Tumors</a> for more information.</p></div></div><div id="CDR0000574295__216"><h3> New types of treatment are being tested in clinical trials.
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</h3><p id="CDR0000574295__218">This summary section describes treatments that are being studied in clinical trials. It may not mention every new treatment being studied. Information about clinical trials is available from the <a href="http://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI website</a>.</p><div id="CDR0000574295__250"><h4>Other drug therapy</h4><p id="CDR0000574295__252"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000393761/" class="def">Lenalidomide</a> is a type of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046739/" class="def">angiogenesis inhibitor</a>. It prevents the growth of new blood vessels that are needed by a tumor to grow.</p></div></div><div id="CDR0000574295__257"><h3>If fluid builds up around the brain and spinal cord, a cerebrospinal fluid diversion procedure may be done.</h3><p id="CDR0000574295__259">
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044801/" class="def">Cerebrospinal fluid diversion</a> is a method used to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000407759/" class="def">drain</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044669/" class="def">fluid</a> that has built up around the brain and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000340937/" class="def">spinal cord</a>. A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046579/" class="def">shunt</a> (long, thin tube) is placed in a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045939/" class="def">ventricle</a> (fluid-filled space) of the brain and threaded under the skin to another part of the body, usually the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045070/" class="def">abdomen</a>. The shunt carries extra fluid away from the brain so it may be absorbed elsewhere in the body.<div class="iconblock whole_rhythm clearfix ten_col fig" id="figCDR0000574295226" co-legend-rid="figlgndCDR0000574295226"><a href="/books/NBK65954.1/figure/CDR0000574295__226/?report=objectonly" target="object" title="Figure" class="img_link icnblk_img figpopup" rid-figpopup="figCDR0000574295226" rid-ob="figobCDR0000574295226"><img class="small-thumb" src="/books/NBK65954.1/bin/CDR0000680517.gif" src-large="/books/NBK65954.1/bin/CDR0000680517.jpg" alt="Cerebrospinal fluid (CSF) diversion" /></a><div class="icnblk_cntnt" id="figlgndCDR0000574295226"><h4 id="CDR0000574295__226"><a href="/books/NBK65954.1/figure/CDR0000574295__226/?report=objectonly" target="object" rid-ob="figobCDR0000574295226">Figure</a></h4><p class="float-caption no_bottom_margin">Cerebrospinal fluid (CSF) diversion. Extra CSF is removed from a ventricle in the brain through a shunt (tube) and is emptied into the abdomen. A valve controls the flow of CSF. </p></div></div></p></div><div id="CDR0000574295__117"><h3>Patients may want to think about taking part in a clinical trial.</h3><p id="CDR0000574295__117_23">For some patients, taking part in a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a> may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044930/" class="def">standard treatment</a>.</p><p id="CDR0000574295__117_24">Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.</p><p id="CDR0000574295__117_25">Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.</p></div><div id="CDR0000574295__119"><h3>Patients can enter clinical trials before, during, or after starting their cancer treatment.</h3><p id="CDR0000574295__119_29">Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046556/" class="def">recurring</a> (coming back) or reduce the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046580/" class="def">side effects</a> of cancer treatment.</p><p id="CDR0000574295__119_30">Clinical trials are taking place in many parts of the country. See the Treatment Options section that follows for links to current treatment clinical trials. These have been retrieved from <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044267/" class="def">NCI's</a> listing of clinical trials. </p></div><div id="CDR0000574295__121"><h3>Follow-up tests may be needed.</h3><p id="CDR0000574295__169">Some of the tests that were done to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046450/" class="def">diagnose</a> the cancer or to find out the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045885/" class="def">stage</a> of the cancer may be repeated. (See the <a href="#CDR0000574295__16">General Information</a> section for a list of tests.) Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests.</p><p id="CDR0000574295__170">Regular <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045788/" class="def">MRIs</a> will continue to be done after treatment has ended. The results of the MRI can show if your child's <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651193/" class="def">condition</a> has changed or if the astrocytoma has <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046556/" class="def">recurred</a> (come back). If the results of the MRI show a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000638197/" class="def">mass</a> in the brain, a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045164/" class="def">biopsy</a> may be done to find out if it is made up of dead tumor cells or if new cancer cells are growing.
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</p></div></div><div id="CDR0000574295__69"><h2 id="_CDR0000574295__69_">Treatment Options for Childhood Astrocytomas</h2><div id="CDR0000574295__150"><h3>Newly Diagnosed Childhood Low-Grade Astrocytomas</h3><p id="CDR0000574295__151">When the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> is first <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046450/" class="def">diagnosed</a>, treatment for childhood <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000386213/" class="def">low-grade</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045602/" class="def">astrocytoma</a> depends where the tumor is, and is usually <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">surgery</a>. An <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045788/" class="def">MRI</a> is done after surgery to see if there is tumor remaining. </p><p id="CDR0000574295__179">If the tumor was completely removed by surgery, more treatment may not be needed and the child is closely watched to see if <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000750109/" class="def">signs</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a> appear or change. This is called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045981/" class="def">observation</a>.
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</p><p id="CDR0000574295__152">If there is tumor remaining after surgery, treatment may include the following:</p><ul id="CDR0000574295__153"><li class="half_rhythm"><div>Observation.</div></li><li class="half_rhythm"><div>A second surgery to remove the tumor.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">Radiation therapy</a>, which may include <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270731/" class="def">conformal radiation therapy</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000335073/" class="def">intensity-modulated radiation therapy</a>, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044464/" class="def">stereotactic radiation therapy</a>, when the tumor begins to grow again.</div></li><li class="half_rhythm"><div>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045650/" class="def">Combination chemotherapy</a> with or without radiation therapy.</div></li><li class="half_rhythm"><div>A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a> of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270742/" class="def">targeted therapy</a> with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000761601/" class="def">selumetinib</a>.</div></li></ul><p id="CDR0000574295__186">In some cases, observation is used for children who have a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046137/" class="def">visual pathway glioma</a>. In other cases, treatment may include surgery to remove the tumor, radiation therapy, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">chemotherapy</a>. A goal of treatment is to save as much vision as possible. The effect of tumor growth on
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the child's vision will be closely followed during treatment. </p><p id="CDR0000574295__187">Children with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045096/" class="def">neurofibromatosis type 1</a> (NF1) may not need treatment unless the tumor grows or signs or symptoms, such as vision problems, appear. When the tumor grows or signs or symptoms appear, treatment may include surgery to remove the tumor, radiation therapy, and/or chemotherapy.</p><p id="CDR0000574295__211">Children with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000304692/" class="def">tuberous sclerosis</a> may develop <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045614/" class="def">benign</a> (not <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a>) tumors in the brain called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000689357/" class="def">subependymal giant cell astrocytomas</a> (SEGAs). Targeted therapy with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000386203/" class="def">everolimus</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045513/" class="def">sirolimus</a> may be used instead of surgery, to shrink the tumors.</p><p id="CDR0000574295__TrialSearch_150_18">Check the list of NCI-supported cancer clinical trials that are now accepting patients with <a href="http://www.cancer.gov/search/ClinicalTrialsLink.aspx?Diagnosis=716317&tt=1&format=1&cn=1" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">childhood low-grade untreated astrocytoma or other tumor of glial origin</a>. 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. Talk with your child's doctor about clinical trials that may be right for your child. General information about clinical trials is available from the <a href="http://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI website</a>.</p></div><div id="CDR0000574295__156"><h3>Recurrent Childhood Low-Grade Astrocytomas</h3><p id="CDR0000574295__188">Before more <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> treatment is given, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000689578/" class="def">imaging tests</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045164/" class="def">biopsy</a>, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">surgery</a> are done to find out if there is cancer and how much there is.</p><p id="CDR0000574295__157">Treatment of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045862/" class="def">recurrent</a> childhood <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000386213/" class="def">low-grade</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045602/" class="def">astrocytoma</a> may include the following:</p><ul id="CDR0000574295__158"><li class="half_rhythm"><div>A second <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">surgery</a> to remove the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a>, if surgery was the only treatment given when the tumor was first <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046450/" class="def">diagnosed</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">Radiation therapy</a> to the tumor only, if radiation therapy was not used when the tumor was first <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046450/" class="def">diagnosed</a>.
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270731/" class="def">Conformal radiation therapy</a> may be given.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">Chemotherapy</a>, if the tumor <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046556/" class="def">recurred</a> where it cannot be removed by surgery or the patient had radiation therapy when the tumor was first diagnosed.</div></li><li class="half_rhythm"><div>Chemotherapy and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270742/" class="def">targeted therapy</a> with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046115/" class="def">bevacizumab</a>.</div></li></ul><p id="CDR0000574295__TrialSearch_156_18">Check the list of NCI-supported cancer clinical trials that are now accepting patients with <a href="http://www.cancer.gov/search/ClinicalTrialsLink.aspx?Diagnosis=716330&tt=1&format=1&cn=1" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">recurrent childhood astrocytoma or other tumor of glial origin</a>. 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. Talk with your child's doctor about clinical trials that may be right for your child. General information about clinical trials is available from the <a href="http://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI website</a>.</p></div><div id="CDR0000574295__209"><h3>Newly Diagnosed Childhood High-Grade Astrocytomas</h3><p id="CDR0000574295__212">Treatment of childhood <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000386205/" class="def">high-grade</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045602/" class="def">astrocytoma</a> may include the following:</p><ul id="CDR0000574295__213"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">Surgery</a> to remove the tumor, followed by <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">chemotherapy</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">radiation therapy</a>.</div></li><li class="half_rhythm"><div>A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a> of chemotherapy with or without radiation therapy.</div></li><li class="half_rhythm"><div>A clinical trial of a new treatment.</div></li></ul><p id="CDR0000574295__TrialSearch_209_18">Check the list of NCI-supported cancer clinical trials that are now accepting patients with <a href="http://www.cancer.gov/search/ClinicalTrialsLink.aspx?Diagnosis=716318&tt=1&format=1&cn=1" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">childhood high-grade untreated astrocytoma or other tumor of glial origin</a>. 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. Talk with your child's doctor about clinical trials that may be right for your child. General information about clinical trials is available from the <a href="http://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI website</a>.</p></div><div id="CDR0000574295__210"><h3>Recurrent Childhood High-Grade Astrocytomas</h3><p id="CDR0000574295__260">Before more <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> treatment is given, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000689578/" class="def">imaging tests</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045164/" class="def">biopsy</a>, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">surgery</a> are done find out if there is cancer and how much there is. </p><p id="CDR0000574295__214">Treatment of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045862/" class="def">recurrent</a> childhood <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000386205/" class="def">high-grade</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045602/" class="def">astrocytoma</a> may include the following:</p><ul id="CDR0000574295__215"><li class="half_rhythm"><div>Surgery.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000346522/" class="def">High-dose chemotherapy</a> with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046695/" class="def">stem cell transplant</a>.</div></li><li class="half_rhythm"><div>A clinical trial of a new treatment.</div></li><li class="half_rhythm"><div>A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a> of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270742/" class="def">targeted therapy</a> with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000750069/" class="def">dabrafenib</a>.</div></li></ul><p id="CDR0000574295__TrialSearch_210_18">Check the list of NCI-supported cancer clinical trials that are now accepting patients with <a href="http://www.cancer.gov/search/ClinicalTrialsLink.aspx?Diagnosis=716330&tt=1&format=1&cn=1" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">recurrent childhood astrocytoma or other tumor of glial origin</a>. 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. Talk with your child's doctor about clinical trials that may be right for your child. General information about clinical trials is available from the <a href="http://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI website</a>.</p></div></div><div id="CDR0000574295__100"><h2 id="_CDR0000574295__100_">To Learn More About Childhood Astrocytomas</h2><p id="CDR0000574295__101"> For more information about childhood astrocytomas, see the following:</p><ul id="CDR0000574295__225"><li class="half_rhythm"><div><a href="http://www.cancer.gov/publications/patient-education/wyntk-brain-tumors" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">What You Need to Know About™ Brain Tumors</a></div></li><li class="half_rhythm"><div><a href="http://www.cancer.gov/about-cancer/treatment/types/targeted-therapies/targeted-therapies-fact-sheet" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Targeted Cancer Therapies</a></div></li><li class="half_rhythm"><div><a href="http://www.pbtc.org/public/gen_info.htm" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Pediatric Brain Tumor Consortium (PBTC)</a></div></li></ul><p id="CDR0000574295__100_44">For more childhood <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> information and other general cancer resources, see the following:</p><ul id="CDR0000574295__100_45"><li class="half_rhythm"><div><a href="http://www.cancer.gov/types/childhood-cancers" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Childhood Cancers</a>
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</div></li><li class="half_rhythm"><div><a href="http://www.curesearch.org/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">CureSearch for Children's Cancer</a>
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</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/CDR0000373791/">Late Effects of Treatment for Childhood Cancer</a></div></li><li class="half_rhythm"><div><a href="http://www.cancer.gov/types/aya" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Adolescents and Young Adults with Cancer</a></div></li><li class="half_rhythm"><div><a href="http://www.cancer.gov/publications/patient-education/young-people" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Young People with Cancer: A Handbook for Parents</a></div></li><li class="half_rhythm"><div><a href="http://www.cancer.gov/types/childhood-cancers/child-adolescent-cancers-fact-sheet" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Cancer in Children and Adolescents</a></div></li><li class="half_rhythm"><div><a href="http://www.cancer.gov/about-cancer/diagnosis-staging/staging/staging-fact-sheet" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Cancer Staging</a></div></li><li class="half_rhythm"><div><a href="http://www.cancer.gov/about-cancer/coping" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Coping with Cancer</a></div></li><li class="half_rhythm"><div><a href="http://www.cancer.gov/about-cancer/coping/questions" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Questions to Ask Your Doctor about Cancer</a></div></li><li class="half_rhythm"><div><a href="http://cancercontrol.cancer.gov/ocs/resources/survivors.html" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">For Survivors and Caregivers</a>
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</div></li></ul></div><div id="CDR0000574295__89"><h2 id="_CDR0000574295__89_">Changes to This Summary (08/26/2015)</h2><p id="CDR0000574295__90">The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044271/" class="def">PDQ</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.</p><p id="CDR0000574295__200">Editorial changes were made to this summary.</p></div><div id="CDR0000574295__AboutThis_1"><h2 id="_CDR0000574295__AboutThis_1_">About This PDQ Summary</h2><div id="CDR0000574295__AboutThis_2"><h3>About PDQ</h3><p id="CDR0000574295__AboutThis_3">Physician Data Query (PDQ) is the National Cancer Institute's (NCI's) comprehensive cancer information database. The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions. The health professional versions have detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate and up to date and most versions are also available in <a href="http://www.cancer.gov/espanol/publicaciones/pdq" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Spanish</a>.</p><p id="CDR0000574295__AboutThis_4">PDQ is a service of the NCI. The NCI is part of the National Institutes of Health (NIH). NIH is the federal government’s center of biomedical research. The PDQ summaries are based on an independent review of the medical literature. They are not policy statements of the NCI or the NIH.</p></div><div id="CDR0000574295__AboutThis_5"><h3>Purpose of This Summary</h3><p id="CDR0000574295__AboutThis_6">This PDQ cancer information summary has current information about the treatment of childhood astrocytomas. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.</p></div><div id="CDR0000574295__AboutThis_7"><h3>Reviewers and Updates</h3><p id="CDR0000574295__AboutThis_8">Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Date Last Modified") is the date of the most recent change.
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</p><p id="CDR0000574295__AboutThis_9">The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the <a href="http://www.cancer.gov/publications/pdq/editorial-boards/pediatric-treatment" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">PDQ Pediatric Treatment Editorial Board</a>.
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</p></div><div id="CDR0000574295__AboutThis_10"><h3>Clinical Trial Information</h3><p id="CDR0000574295__AboutThis_11">A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
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</p><p id="CDR0000574295__AboutThis_12">Clinical trials are listed in PDQ and can be found online at <a href="http://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI's website</a>. Many cancer doctors who take part in clinical trials are also listed in PDQ. For more information, call the Cancer Information Service 1-800-4-CANCER (1-800-422-6237).
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</p></div><div id="CDR0000574295__AboutThis_13"><h3>Permission to Use This Summary</h3><p id="CDR0000574295__AboutThis_14">PDQ is a registered trademark. The content of PDQ documents can be used freely as text. It cannot be identified as an NCI PDQ cancer information summary unless the whole summary is shown and it is updated regularly. However, a user would be allowed to write a sentence such as “NCI’s PDQ cancer information summary about breast cancer prevention states the risks in the following way: [include excerpt from the summary].”
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</p><p id="CDR0000574295__AboutThis_15">The best way to cite this PDQ summary is:</p><p id="CDR0000574295__AboutThis_21">National Cancer Institute: PDQ® Childhood Astrocytomas Treatment. Bethesda, MD: National Cancer Institute. Date last modified <MM/DD/YYYY>. Available at: <a href="http://www.cancer.gov/types/brain/patient/child-astrocytoma-treament-pdq" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">http://www.cancer.gov/types/brain/patient/child-astrocytoma-treament-pdq</a>. Accessed <MM/DD/YYYY>.</p><p id="CDR0000574295__AboutThis_16">Images in this summary are used with permission of the author(s), artist, and/or publisher for use in the PDQ summaries only. If you want to use an image from a PDQ summary and you are not using the whole summary, you must get permission from the owner. It cannot be given by the National Cancer Institute. Information about using the images in this summary, along with many other images related to cancer can be found in <a href="http://visualsonline.cancer.gov/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Visuals Online</a>. Visuals Online is a collection of more than 2,000 scientific images.
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</p></div><div id="CDR0000574295__AboutThis_17"><h3>Disclaimer</h3><p id="CDR0000574295__AboutThis_18">The information in these summaries should not be used to make decisions about insurance reimbursement. More information on insurance coverage is available on Cancer.gov on the <a href="http://www.cancer.gov/about-cancer/managing-care" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Managing Cancer Care</a> page.</p></div><div id="CDR0000574295__AboutThis_19"><h3>Contact Us</h3><p id="CDR0000574295__AboutThis_20">More information about contacting us or receiving help with the Cancer.gov website can be found on our <a href="http://www.cancer.gov/contact" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Contact Us for Help</a> page. Questions can also be submitted to Cancer.gov through the website’s <a href="http://www.cancer.gov/contact/email-us" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">E-mail Us</a>.</p></div></div><div id="CDR0000574295__GetMore_3"><h2 id="_CDR0000574295__GetMore_3_">Get More Information From NCI</h2><p id="CDR0000574295__GetMore_15"><i><b>Call 1-800-4-CANCER</b></i></p><p id="CDR0000574295__GetMore_16">For more information, U.S. residents may call the National Cancer Institute's (NCI's) Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237) Monday through Friday from 8:00 a.m. to 8:00 p.m., Eastern Time. A trained Cancer Information Specialist is available to answer your questions.</p><p id="CDR0000574295__GetMore_25"><i><b>Chat online
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</b></i></p><p id="CDR0000574295__GetMore_26">The <a href="https://livehelp.cancer.gov/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI's LiveHelp®</a> online chat service provides Internet users with the ability to chat online with an Information Specialist. The service is available from 8:00 a.m. to 11:00 p.m. Eastern time, Monday through Friday. Information Specialists can help Internet users find information on NCI websites and answer questions about cancer.
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</p><p id="CDR0000574295__GetMore_27"><i><b>Write to us</b></i></p><p id="CDR0000574295__GetMore_28">For more information from the NCI, please write to this address:</p><ul id="CDR0000574295__GetMore_29" class="simple-list"><li class="half_rhythm"><div>NCI Public Inquiries Office</div></li><li class="half_rhythm"><div>9609 Medical Center Dr. </div></li><li class="half_rhythm"><div>Room 2E532 MSC 9760</div></li><li class="half_rhythm"><div>Bethesda, MD 20892-9760</div></li></ul><p id="CDR0000574295__GetMore_17"><i><b>Search the NCI websites</b></i></p><p id="CDR0000574295__GetMore_18">The <a href="http://www.cancer.gov/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI website</a> provides online access to information on cancer, clinical trials, and other websites and organizations that offer support and resources for cancer patients and their families. For a quick search, use the search box in the upper right corner of each web page. The results for a wide range of search terms will include a list of "Best Bets," editorially chosen web pages that are most closely related to the search term entered.</p><p id="CDR0000574295__GetMore_30">There are also many other places to get materials and information about cancer treatment and services. Hospitals in your area may have information about local and regional agencies that have information on finances, getting to and from treatment, receiving care at home, and dealing with problems related to cancer treatment.</p><p id="CDR0000574295__GetMore_19"><i><b>Find Publications</b></i></p><p id="CDR0000574295__GetMore_20">The NCI has booklets and other materials for patients, health professionals, and the public. These publications discuss types of cancer, methods of cancer treatment, coping with cancer, and clinical trials. Some publications provide information on tests for cancer, cancer causes and prevention, cancer statistics, and NCI research activities. NCI materials on these and other topics may be ordered online or printed directly from the <a href="https://pubs.cancer.gov/ncipl" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI Publications Locator</a>. These materials can also be ordered by telephone from the Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237).</p></div></div></div>
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<div xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Views</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="PDF_download" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="/books/NBK65954.1/?report=reader">PubReader</a></li><li><a href="/books/NBK65954.1/?report=printable">Print View</a></li><li><a data-jig="ncbidialog" href="#_ncbi_dlg_citbx_NBK65954" data-jigconfig="width:400,modal:true">Cite this Page</a><div id="_ncbi_dlg_citbx_NBK65954" style="display:none" title="Cite this Page"><div class="bk_tt">PDQ Pediatric Treatment Editorial Board. Childhood Astrocytomas Treatment (PDQ®): Patient Version. 2015 Aug 26. 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2016</li><li><span class="bk_col_itm"><a href="/books/NBK65954.3/">NBK65954.3</a></span> August 11, 2016</li><li><span class="bk_col_itm"><a href="/books/NBK65954.2/">NBK65954.2</a></span> September 28, 2015</li><li><span class="bk_col_itm">NBK65954.1</span> August 26, 2015 (Displayed Version)</li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>In this Page</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="page-toc" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="#CDR0000574295__1" ref="log$=inpage&link_id=inpage">General Information About Childhood Astrocytomas</a></li><li><a href="#CDR0000574295__26" ref="log$=inpage&link_id=inpage">Stages of Childhood Astrocytomas</a></li><li><a href="#CDR0000574295__31" ref="log$=inpage&link_id=inpage">Recurrent Childhood Astrocytomas</a></li><li><a href="#CDR0000574295__33" ref="log$=inpage&link_id=inpage">Treatment Option Overview</a></li><li><a href="#CDR0000574295__69" ref="log$=inpage&link_id=inpage">Treatment Options for Childhood Astrocytomas</a></li><li><a href="#CDR0000574295__100" ref="log$=inpage&link_id=inpage">To Learn More About Childhood Astrocytomas</a></li><li><a href="#CDR0000574295__89" ref="log$=inpage&link_id=inpage">Changes to This Summary (08/26/2015)</a></li><li><a href="#CDR0000574295__AboutThis_1" ref="log$=inpage&link_id=inpage">About This PDQ Summary</a></li><li><a href="#CDR0000574295__GetMore_3" ref="log$=inpage&link_id=inpage">Get More Information From NCI</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Related publications</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="document-links" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="/books/NBK65944/">Health Professional Version</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Similar articles in PubMed</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="PBooksDiscovery_RA" id="Shutter"></a></div><div class="portlet_content"><ul><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/26389295" ref="ordinalpos=1&linkpos=1&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Childhood Brain Stem Glioma Treatment (PDQ®): Patient Version.</a><span class="source">[PDQ Cancer Information Summari...]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Childhood Brain Stem Glioma Treatment (PDQ®): Patient Version.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">PDQ Pediatric Treatment Editorial Board. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">PDQ Cancer Information Summaries. 2002</em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/26389351" ref="ordinalpos=1&linkpos=2&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Childhood 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xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Childhood Ovarian Cancer (PDQ®): Patient Version.</a><span class="source">[PDQ Cancer Information Summari...]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Childhood Ovarian Cancer (PDQ®): Patient Version.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">PDQ Pediatric Treatment Editorial Board. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">PDQ Cancer Information Summaries. 2002</em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/29337481" ref="ordinalpos=1&linkpos=5&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Childhood Oral Cavity Cancer (PDQ®): Patient Version.</a><span class="source">[PDQ Cancer Information Summari...]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Childhood Oral Cavity Cancer (PDQ®): Patient Version.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">PDQ Pediatric Treatment Editorial Board. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">PDQ Cancer Information Summaries. 2002</em></div></div></li></ul><a class="seemore" 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