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Childhood brain and spinal tumours

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Treatment of primitive neuroectodermal tumours (PNETs)

Treatment of PNETs, other than medulloblastomas, depends on:

  • the size and type of tumour
  • whether the cancer has spread to other areas of the brain or spinal cord
  • the age of the child

PNETs are generally harder to treat than medulloblastomas. Treatment for ependymoblastomas, pineal tumours and cerebral neuroblastomas includes:

Surgery

Surgery is done to remove as much of the tumour as possible without affecting brain functions. Complete resection is often not possible because these tumours can be quite large and often invade surrounding structures. In these cases, the goal of surgery is to relieve pressure on the surrounding brain and leave as little tumour as possible so that radiation and chemotherapy can be more effective.

Radiation therapy

Radiation therapy is usually given after surgery to treat as many remaining cancer cells as possible. Radiation may be given to the entire brain and spinal cord because of the tendency of these tumours to spread to those areas. In children under 3 years of age, radiation therapy can damage developing brain cells. In these cases, chemotherapy may be given first and then followed by radiation once the child is over the age of 3 years.

Chemotherapy

Chemotherapy is a common treatment for PNETs. It is usually given either with radiation therapy or after radiation therapy is finished. There are a number of single drugs and combinations of chemotherapy drugs that work against PNETs. Chemotherapy is used in children under the age of 3 years to delay the need for radiation therapy until the child is older. In some cases, radiation may not be needed at all after chemotherapy.

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