Adjuvant Therapies for Brainstem Gliomas in Children

Adjuvant therapy for brainstem tumors depends on the tumor’s location, the pathological diagnosis, and the extent of previous surgical resection.  Indications for radiation therapy, chemotherapy, or observation alone are reviewed separately below for each tumor subtype.

Radiation

  • Focal gliomas of the brainstem: In general, radiation is reserved for tumors that have shown signs of growth and that have been found to be unresectable.
  • Dorsally exophytic gliomas: Radiation is used to manage dorsally exophytic tumors that are progressing clinically and that are not amenable to further surgery.
  • Diffuse intrinsic pontine gliomas: Radiation is the mainstay treatment for these tumors.
  • Cervicomedullary gliomas: Radiation is used for these tumors when further surgery is deemed not possible and clinical progression is being experienced or is anticipated.

Chemotherapy

  • Chemotherapy of unproven benefit: While generally used in combination with radiation, there is currently no proven efficacy for any chemotherapy protocol for managing brainstem gliomas.