Childhood brain and spinal tumours

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Optic and hypothalamic gliomas

Optic and hypothalamic gliomas are both a type of low-grade glioma. They are usually benign, slow-growing tumours. Optic gliomas start along the nerves for sight. Hypothalamic gliomas start in the hypothalamus.

Recurrent optic and hypothalamic gliomas are tumours that have come back after treatment.

Treatment of optic and hypothalamic gliomas

The main goal of treatment is to save the child’s sight and hormone functions. Treatment for optic and hypothalamic gliomas depends on the:

  • child’s age and general health
  • location and size of the tumour
  • extent of vision loss or other symptoms

Children with neurofibromatosis often have more slow-growing tumours. If the tumour is not growing, it may be left untreated and checked regularly with MRIs.

Treatment will be given if the tumour is large, if the tumour is growing, if there is a threat to the child’s sight or if symptoms are getting worse.

Children younger than 1 often have a more aggressive tumour and require more urgent treatment.

Surgery

Surgery is only used if the tumour is easily accessible and can be safely removed or if symptoms are getting worse. Surgery for optic and hypothalamic tumours is difficult as the tumours are often difficult to reach. They often invade the nerve leading to the eye, and surgery can result in the loss of vision in one or both eyes. Surgery may also be used to relieve a buildup of cerebrospinal fluid (CSF).

Radiation therapy

Radiation therapy is the main treatment when surgery cannot be done and treatment is needed. It can shrink the tumour or slow its growth. In children under 3 years old, radiation therapy can be damaging to developing brain cells. In these cases, chemotherapy may be given first, followed by radiation therapy, if needed, once the child is over the age of 3.

Chemotherapy

Chemotherapy has shown some success in treating these tumours. It can shrink the tumour and delay the need for radiation in young children. Chemotherapy treatment usually lasts for a year or longer. It is often given as an outpatient treatment, which means that your child will not have to stay overnight. The most common chemotherapy drugs used are vincristine (Oncovin) and carboplatin (Paraplatin, Paraplatin AQ).

Active surveillance

Active surveillance may be an option if the tumour is not growing and there are no symptoms. The child will be watched closely using MRIs for any signs of tumour growth. Treatment is started when the tumour progresses.

Treatment for recurrent optic and hypothalamic gliomas

Treatment for recurrent tumours will depend on previous treatments used and how your child responded to these treatments.

Chemotherapy is commonly used. Radiation therapy may also be used.

Clinical trials

Many children with optic and hypothalamic gliomas are treated in a clinical trial. Clinical trials look at new ways to prevent, find and treat cancer. Find out more about clinical trials.

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