• Thalamic Astrocytoma and Hypothalamic Astrocytoma

    Thalamic astrocytoma and hypothalamic astrocytoma are both a type of glioma (which is a type of brain tumor), meaning that they arise in the brain’s glial or supportive tissues.

    • Thalamic and hypothalamic astrocytomas develop in the thalamus – a deep-lying part of the brain responsible for identification of sensation, such as temperature, pain and touch, and a relay center for movement; or the hypothalamus – the brain area just below the thalamus responsible for hormone functioning, body temperature, sleep and appetite.
    • Sometimes these tumors can invade both areas.

    Thalamic and Hypothalamic Astrocytoma Treatment at Dana-Farber/Boston Children's

    Children and adolescents with thalamic and hypothalamic astrocytomas are treated through our Glioma Program, one of the largest and most experienced pediatric glioma programs in the world, and part of the Dana-Farber/Boston Children’s Brain Tumor Center.

    Our glioma specialists – a team of neuro-oncologists, surgeons, pathologists and radiation oncologists – focus solely on the care of children diagnosed with gliomas. The Glioma Program also offers families the chance to have their child's tumor molecularly profiled (as long as a biopsy can be taken), which may help identify opportunities for targeted treatment.

    What are thalamic and hypothalamic astrocytoma symptoms?

    Since thalamic and hypothalamic astrocytomas grow relatively slowly, a child may have been having symptoms for many months prior to diagnosis, or his symptoms may appear more suddenly. Many symptoms are associated with increased pressure in the brain, including:

    • Headache – generally upon awakening in the morning
    • Nausea and vomiting – often worse in the morning and improving throughout the day
    • Fatigue
    • Weakness on one side of the body
    • Symptoms of hormone imbalance, including weight loss/gain
    • Symptoms of salt and water imbalance, including retaining water, swelling and frequent urination
    • Changes in vision (since the thalamus and hypothalamus are found close to the visual pathway system in the brain)

    How are thalamic and hypothalamic astrocytomas diagnosed?

    A physician may order a number of different tests to best diagnose thalamic or hypothalamic astrocytoma, including: 

    • A physical exam, medical history and neurological exam (which tests reflexes, muscle strength, eye and mouth movement, coordination and alertness),
    • magnetic resonance imaging (MRI): a diagnostic procedure that uses a combination of large magnets, radiofrequencies and a computer to produce detailed images of the brain and spine.
    • biopsy: In many cases, a tissue sample from the tumor will be taken through a needle during a simple surgical procedure to confirm the diagnosis. 

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

    What are thalamic and hypothalamic astrocytoma treatment options?

    A number of treatments may be recommended for thalamic or hypothalamic astrocytomas. Some help treat the tumor, while others address complications of the disease or side effects of treatment. These include:

    • Neurosurgery – to remove as much of the tumor as safely possible; surgery is often limited due to the deep, central placement of the thalamus and hypothalamus in the brain
    • Chemotherapy – either before surgery to shrink the tumor or to kill cancer cells 
    • Radiation therapy – precisely targeted treatment to control local growth of tumors; not recommended unless the child’s tumor has re-grown due to potential long-term side effects of therapy

    Progressive or recurrent disease

    There are many standard and experimental treatment options for children with recurrent or progressive thalamic or hypothalamic astrocytomas. If a tumor recurs after initial surgical removal or the tumor re-grows after partial removal, a doctor may recommend a second attempt at removing as much of the tumor as possible.

    What is the latest thalamic and hypothalamic astrocytoma research?

    Dana-Farber/Boston Children's is home to the Pediatric Low-Grade Astrocytoma (PLGA) Research Program, the world's largest program dedicated to pediatric low-grade gliomas like thalamic and hypothalamic astrocytomas. The program conducts advanced research on the causes and treatment of low-grade gliomas.

    Through the PLGA program, we have pioneered strategies for analyzing the genetic and molecular characteristics of pediatric low-grade astrocytomas, established a patient registry and multiple international research projects and initiated a number of early phase clinical trials using molecular inhibitors for children with progressive/recurrent low-grade gliomas. And, in collaboration with the Broad Institute of Harvard and Massachusetts Institute of Technology, we have made strides toward a better understanding of these conditions.

    What is the long-term outlook for children with thalamic and hypothalamic astrocytoma?

    Children with thalamic or hypothalamic astrocytomas have a high rate of survival. The survival rate is not as high if the tumor can’t be removed completely during surgery or if the tumor returns.

    Many brain tumor survivors face physical, psychological, social and intellectual challenges related to their treatment and will require ongoing assessment and specialized care.

    To address the needs of this growing community of brain tumor survivors, Dana-Farber/Boston Children's established the Stop & Shop Family Pediatric Neuro-Oncology Outcomes Clinic. This multi-disciplinary program addresses long-term health and social issues for families and survivors of childhood brain tumors.

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