Brain Tumors in Children – Treatment Options
Having brain tumors can be extremely devastating, but there are some treatment options that can make a difference in your child’s life. This article looks at radiation, surgery, and targeted therapies.
Radiation therapy
Depending on the size, location, and stage of the tumor, radiotherapy can be a major treatment for children with brain tumors. There are two main types of radiation therapy: external beam and internal beam.
External beam radiation uses specialized machines that aim radiation beams at the tumor. This type of treatment can focus on the entire brain or on surrounding healthy tissue.
Internal beam radiation therapy uses a radioactive isotope that is placed inside the tumor. The amount of radiation emitted by the isotope is high enough to destroy the tumor but not so high that it harms normal brain cells.
Radiation therapy for brain tumors in children is usually postponed for younger children, due to the dangers associated with radiation to developing brains. Some children may be given an anesthetic before receiving radiation. The dose of radiation is usually very small and may not be painful.
Children may receive radiation therapy to the entire brain or spinal cord. Some children will also have radiotherapy after surgery. Other children may have radiation therapy and chemotherapy together. The combination of chemotherapy and radiation is thought to improve the effect of radiation.
Children may be given a special treatment mask to protect their faces from radiation. The mask is made of plastic and is fitted to the child’s face. It will keep the child’s head in the same position throughout the treatment. The mask will be removed once the treatment is over.
A child’s brain is very sensitive to small amounts of radiation. Because of this, the treatment area is determined by the size of the tumor and the child’s general health. In general, a child’s radiation treatment plan will last about four to six weeks. During this time, the child will have about one treatment a day, or once a week. The treatment will usually be a few minutes long and will be followed by a break on weekends.
Some treatment rooms offer music docks and projectors. These devices allow the child to watch programs while they are receiving treatment. Some children also receive sleep medicine to keep them from moving around during treatment.
Surgery
Surgical treatment is usually the first option for children with brain tumors. The goal of surgery is to remove as much of the tumor as possible without harming healthy brain tissue. Depending on the type of tumor, surgery can be performed in many ways.
Pediatric neurosurgeons evaluate the patient to find the best course of treatment. The most common treatments for childhood brain tumors include surgery and radiation therapy. Chemotherapy is also sometimes used. However, chemotherapy is not as effective as it is for other types of cancer.
Brain tumors can be benign or malignant. Benign pediatric brain tumors are slow-growing and tend to compress important structures in the brain. Malignant tumors tend to be aggressive and often require chemotherapy and radiation therapy.
The type of surgery performed depends on the size of the tumor and the age of the child. A highly skilled pediatric neurosurgeon will perform the surgery. A piece of the skull will be removed to expose the tumor. Small screws and plates are placed in the area of the tumor. The skull is then replaced when the swelling has gone down.
A general anesthetic is used for the child. When the mapping is completed, the child is given a second general anesthetic. The skull is opened to allow access to the brain. A special operating microscope is used to identify the edges of the tumor.
The type of surgery and the amount of tumor removed will depend on the child’s age and general health. Pediatric neurosurgeons will monitor the patient in an intensive care unit for post-operative complications.
For younger children, treatment modalities are still being evaluated. Some authors question the use of re-operating on stable residual masses. However, there are studies that demonstrate improved long-term survival when more than 90% of the tumor is removed.
In some children, side effects may persist for months or even years after surgery. However, the majority of the side effects will resolve on their own. In addition, some children have few side effects.
Pediatric neurosurgeons will perform a brain map to locate the tumor and identify important areas that will be affected by surgery. They will then use this map to guide the surgery. They will also use intraoperative cartography to locate areas of the brain that are critical for speech and movement.
Targeted therapies
Molecular-targeted therapies have been a promising new approach for brain tumors in children. These treatments focus on specific genes that are important for normal brain development. The goal is to prevent the tumor from growing and to reduce the side effects associated with traditional treatments.
In the United States, about 2,200 children and adolescents are diagnosed with brain tumors each year. These cancers are often benign, but they can be malignant. The most common type is glioma, which grows in the brain or spinal cord. A child with this cancer may not live much longer than an adult and can suffer severe side effects from treatment.
Treatment involves surgery to remove the tumor, and chemotherapy to kill cancer cells that remain after surgery. Chemotherapy can cause cognitive impairment, as well as long-term side effects. The goal is to kill rapidly dividing cells and stop cancer from growing. In addition, radiation therapy can be used to kill the cancer cells that have been left behind after surgery. This therapy may be delivered to the entire spine or to just the tumor.
The Molecular Characterization Initiative, launched by the National Cancer Institute (NCI) in March, allows young patients to test their tumors to see which biomarkers might be helpful in treatment. Some of these markers include recurrent ALK/NTRK/ROS1/MET fusions. These fusions are very common and represent alterations that can be targeted by clinical trials.
Targeted therapy may be better than chemotherapy for some children. The first study to test this approach is a new trial involving dabrafenib and trametinib for children as young as one year old. The researchers found that the combination of the drugs kept the tumors from growing and had fewer side effects than chemotherapy.
In addition, researchers have discovered that the risk of viral infections is significantly higher for pediatric brain tumor patients receiving targeted therapies. These treatments also reduce the risk of developing new tumors, which can be particularly dangerous for children with brain tumors.
Molecular-targeted therapy for pediatric brain tumors is still in the early stages of development, but scientists are hoping that it will lead to a more effective and safer treatment in the future. This is especially important because pediatric brain tumors are often high-risk, and many of these cancers recur or worsen over time.
Treatment options
Various treatment options for brain tumors in children are available, and each is tailored to the child’s age and condition. Treatment may include surgery, radiation, or chemotherapy. These treatments are designed to target specific tumors and may have different side effects. It is important to discuss these options with your doctor.
Surgery is the most common type of treatment for children with brain tumors. It can be performed using a craniotomy, which is an opening in the skull that allows the surgeon to get a better view of the tumor. If the tumor is found to be malignant, a surgeon will remove as much of it as possible without harming nearby healthy brain tissue.
Children may also have chemotherapy, which involves drugs that target specific cancer cells. These drugs are usually given orally or intravenously. Some children may also receive anti-seizure drugs. Occasionally, a shunt is also placed in the brain, which drains into a small plastic receptacle outside the skull. This may be permanent but is not visible after treatment.
Pediatric patients may also be given corticosteroids, which can reduce the pressure on the brain. These drugs can also help improve neurological symptoms, such as headaches, and decrease swelling in healthy brain tissue.
Radiation is used to kill cancer cells that remain after surgery. It is typically given to the entire brain but may be given in several fractions to reduce side effects.
In some children, chemotherapy is given prior to radiation. This may be to reduce the size of the tumor or to delay radiation treatment until the tumor is smaller. Depending on the type of tumor, chemotherapy may be given to the patient daily or weekly during radiation treatment.
Children with certain types of brain tumors may also be treated with proton beam therapy, which delivers higher doses of radiation to the tumor while minimizing exposure to nearby healthy tissue. This type of radiation is only available at a few major healthcare facilities in the United States. This treatment also reduces the long-term side effects of radiation treatment.
Pediatric patients are often treated through the Brain Tumor Center at Dana-Farber Cancer Institute. This hospital is a leading authority in treating pediatric brain tumors and offers customized treatment options that are tailored to the child’s age and condition.
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