If a child has a childhood cerebral astrocytoma, the doctor will order additional tests to learn more about the tumor. If a biopsy specimen is taken, the tumor cells will be examined carefully under a microscope to see how they look compared to normal cells. This will determine the grade of the tumor. Cells from higher-grade, more abnormal-looking tumors usually grow faster and are more cancerous than cells from lower-grade tumors. The child's doctor needs to know the type and grade of tumor in order to plan treatment.
There is no staging for childhood cerebral astrocytoma. The type of treatment given depends on the grade of the tumor, its location, and whether or not your child has received previous treatment.
Low-Grade Cerebral Astrocytoma:
Low-grade tumors (tumors that look similar to normal astrocytes) do not usually grow quickly or spread from where they start. Treatment depends on whether all of the cancer can be removed during surgery. If the cancer can be removed during surgery, there may be no more treatment needed. If there is cancer left after surgery, radiation therapy may be given, or the doctor may wait until the cancer has started to grow again before giving radiation therapy. Chemotherapy is being studied for the treatement of some groups of children, including those younger than 5 years of age.
High-Grade Cerebral Astrocytoma:
High-grade tumors (tumors that do not look much like normal astrocytes) grow quickly and often spread from where they start to other parts of the brain. Treatment will probably be surgery followed by radiation therapy and chemotherapy. Clinical trials are evaluating surgery followed by chemotherapy with or without radiation therapy. Children younger than 3 years of age may be given chemotherapy to delay radiation therapy, or they may receive a lower dose of radiation may be given.
Recurrent Cerebral Astrocytoma:
Recurrent disease means that the cancer has come back (recurred) after it has been treated. It may come back in the brain or in another part of the body. Treatment for recurrent disease depends on the type of tumor, whether the tumor comes back in the same place or in another part of the brain, and what treatment was given previously. For recurrent low-grade cerebral astrocytoma, surgery and chemotherapy may be given. Parents may want to consider entering their child in a clinical trial of new chemotherapy drugs. For recurrent high-grade cerebral astroctyoma, surgery may be given. Parents should consider having their child entered in a clinical trial of new chemotherapy drugs or new ways of giving therapy.