Pediatric Brain Tumor Treatment

Chemotherapy is a medicine that attacks cancer cells. Often, the drugs in chemotherapy stop cancer cells from growing and reproducing and can reduce the tumor’s size. Chemotherapy (or chemo) may be given through a vein (IV) or spinal canal, injected into a muscle, or taken by mouth.  There are several medicines that make up chemotherapy and they are often given at different times. Treatment can have side effects and can be hard on the body, so it is usually done in cycles, with rest periods in between. This gives your child time to recover.    

Gamma Knife radiosurgery is a minimally invasive procedure that is an option when surgery is not possible. It uses highly precise amounts of radiation to target the brain tumor and does not require any incisions.  

Another approach to chemotherapy can take place alongside a stem cell transplant. First, young blood cells, called stem cells, are taken from the child or from a donor. Then, high doses of chemotherapy medicine can be administered. This causes damage to the bone marrow, where new blood cells are made. After the chemotherapy, the stem cells are replaced, which allows the child’s body to begin making new, healthy blood cells. 

Intraoperative MRI is a treatment that uses magnetic resonance imaging (MRI) to view the brain during surgery. This clear imaging allows surgeons a precise view of the tumor as they work to remove it from the healthy tissue. This ability to see the tumor can reduce the number of surgeries needed to remove all of the cancer cells. Siteman Kids is one of a very few facilities in the nation that are equipped with this technology. 

Immunotherapy utilizes the body’s immune system to recognize tumors as abnormal so that it can target and kill cancer cells.  

MRI-guided Laser Interstitial Thermal Therapy (LITT) is a minimally invasive procedure that uses a laser to destroy brain tumor tissue as an alternative to traditional open surgery, offering the advantage of shorter recovery and reduced pain. This technique can be considered for some types of benign brain tumors as well as to treat seizures related to brain tumors.

Radiation therapy uses high energy beams of radiation to treat brain tumors.  Radiation kills cancer cells and plays an important role in treatment for many pediatric brain tumors.  Radiation can be delivered with x-rays, protons, or gamma rays. 

Radiation is a non-invasive treatment where the radiation beam travels through the air.  Children must lie down and hold very still for treatment.  For younger children, they may require sedation in order to complete the treatments.  Our team works hard to minimize anxiety for all of our patients.  Children are able to watch videos or listen to music during treatments and we work with each child to minimize the need for sedation when possible. 

Radiation treatment options for brain tumors include: 

• X-ray radiation uses x-rays or photons to deliver treatment to the brain.  There are different ways these x-rays can be delivered into the brain, including volumetric modulated arc therapy (VMAT) and intensity modulated radiation therapy (IMRT). 

• Proton Beam therapy uses a different form of radiation, proton particles, to destroy cancer cells. Proton particles act differently than other forms of radiation because they can be more controlled as they deliver radiation to the tumor. Because the proton particles are precise, they can limit how much normal tissue is exposed to radiation, keeping it healthy while treating tissues deep in the tumor. Sparing normal, healthy tissue in the brain is especially important for pediatric patients since their brains are growing and developing.  While x-ray therapy is widely available in the United States, proton therapy is a specialized treatment that is not as widely available. Siteman Kids uses  two proton therapy machines, both with pencil beam scanning (PBS) technology, the most advanced type of proton therapy that provides very focused radiation treatment plans. 

Surgery is often the first intervention used with pediatric brain tumors. As much of the tumor is surgically removed as possible.  

Targeted therapy is a cutting-edge form of precision medicine that works in proteins found in the body. They work on the specific pathways that lead to tumor growth so they do not have the same side effects that chemotherapy does. 

Clinical trials are research studies designed to give patients access to innovative treatments before they are available everywhere while providing valuable information about treating pediatric cancers. Clinical trials for children often take place at multiple locations across the nation. Siteman Kids is proud to lead some of these research efforts. Learn more about pediatric clinical trials for brain tumors here.