• Low-grade Glioma Overview

    Low-grade gliomas are a slow-growing, less aggressive kind of tumor that can grow in a number of places in the brain and spinal cord. The good news is that, in general, children with low-grade gliomas have better long-term health than those with malignant, high-grade tumors.

    Low-grade gliomas are the most common brain tumor in children. They come from a type of brain cell, called a glial cell, that supports and protects the brain. Most come from a type of glial cell called an astrocyte, so they are also called astrocytomas. These tumors may be classified according to their location in the brain: low-grade cerebellar astrocytomas, including cerebellar pilocytic astrocytoma (cerebellum); cervico-medullary astrocytoma (brainstem); optic pathway glioma (optic nerve); thalamic/hypothalamic astrocytoma (thalamus/hypothalamus).

    Low-grade Glioma Treatment at Dana-Farber/Boston Children's

    Patients with low-grade gliomas 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 gliomas or visit the Glioma Program homepage to learn about our expertise and approach to treating this condition.

    Symptoms & Diagnosis

    The most common symptoms include

    • changes in or loss of vision due to a tumor in the visual pathway,
    • weight gain or loss and/or premature puberty due to a tumor in the brain’s hormone center,
    • problems with movement and bowel/bladder control due to a tumor in the spine,
    • seizures due to irritation of normal brain cells,
    • and vomiting, headache, fatigue and motor control problems due to fluid build-up and increased pressure on the brain.

    In addition to a physical exam, medical history and neurological exam (which tests reflexes, muscle strength, eye and mouth movement, coordination and alertness), doctors may requests tests, including:

    After all necessary tests are complete, the best treatment options can be identified.

    Treatment & Care Options

    Your child’s physician will determine a specific course of treatment based on several factors. Some therapies will treat the tumor while others are intended to address complications of the disease or side effects of the treatment. These treatments include:

    These treatments may be used alone or in combination. In addition, through the low-grade glioma research program at Dana-Farber/Boston Children's a number of less toxic biologic targeted therapies for pediatric low-grade gliomas are now available.

    There can be side effects related to the tumor itself or its treatment. Knowing what these side effects are can help the care team prepare for and, in some cases, prevent these symptoms from occurring.

    Progressive or Recurrent Disease

    There are numerous standard and experimental treatment options for children with progressive or recurrent low-grade gliomas. Dana-Farber/Boston Children's is one of nine institutes in the nation belonging to the Pediatric Oncology Experimental Therapeutic Investigators Consortium, which is dedicated to developing new and innovative treatments for children with newly diagnosed, progressive or recurrent brain tumors. We are also home to the world’s largest pediatric low-grade glioma research program, the Pediatric Low-Grade Astrocytoma (PLGA) Program.

    Long-term Outlook

    The outlook for children with low-grade gliomas can vary significantly depending on the location of the tumor, whether it has spread, and whether it can be completely surgically removed. Grade I tumors are usually cured with complete surgical removal. In general, low-grade gliomas have a more positive prognosis than malignant, high-grade brain tumors and the majority of patients are long term survivors.
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