• Low-Grade Cerebellar Astrocytoma in Children

    Low-grade cerebellar astrocytomas are tumors that occur in the cerebellum, the part of the brain that controls balance and coordination. These tumors are classified as a gliomas, meaning that they arise in the brain’s glial or supportive tissues (they are sometimes called low-grade cerebellar gliomas). Because they are “low-grade” tumors, they’re slow-growing and less aggressive than high-grade tumors. They have a higher chance of cure, too.

    Low-Grade Cerebellar Astrocytoma Treatment at Dana-Farber/Boston Children's

    Children with low-grade cerebellar astrocytomas, including cerebellar pilocytic astrocytoma, are treated at Dana-Farber/Boston Children's Cancer and Blood Disorders Center through our Glioma Program. Continue reading to learn more about low-grade cerebellar astrocytomas or visit the Glioma Program homepage to learn about our expertise and treatment options for this condition.

    Symptoms & Diagnosis

    These tumors, which account for 10 to 20 percent of all childhood brain tumors, tend to occur before a child is age 10, and are most common between the ages of 6 and 9.

    Since cerebellar low-grade astrocytomas grow relatively slowly, a child may have symptoms for many months before a diagnosis is made, or the symptoms may appear more suddenly. More than 90 percent of children with these tumors have symptoms related to increased pressure in the brain, including:

    • Headache, generally upon awakening in the morning
    • Nausea and vomiting, which is often worse in the morning and improves throughout the day
    • Fatigue
    • Lack of coordination (ataxia), because the cerebellum is affected

    In addition to a complete medical history, physical examination and neurological exam, which tests reflexes, muscle strength, eye and mouth movement, and coordination and alertness, cerebellar low-grade astrocytomas are diagnosed with:

    • Diagnostic imaging
    • Resection or biopsy – in most cases, these tumors can be removed with surgery; if not, a biopsy can confirm the diagnosis

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

    Treatment & Care Options

    Some treatments for cerebellar low-grade astrocytoma help to treat the tumor while others are intended to address complications of the disease or side effects of treatment. These treatments include neurosurgery, chemotherapy and/or radiation therapy.

    Progressive or Recurrent Disease

    Cerebellar low-grade astrocytomas may recur many years after a patient’s initial treatment. Recurrent tumors are typically treated with a second surgery and chemotherapy and/or radiation therapy. There are many standard and experimental treatment options for children with progressive or recurrent cerebellar low-grade astrocytomas.

    Long-term Outlook

    The prognosis for children with cerebellar low-grade astrocytoma is excellent. Children with grade I tumors, the least severe, have a 10-year survival rate of 90 to 100 percent with surgical removal alone. Grade II tumors are more likely to reappear after they have been removed by surgery. The majority of children with these tumors will survive into adulthood. Many of them, however, will face physical, psychological, social and intellectual challenges related to their treatment and will require ongoing assessment and specialized care.
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