High-grade Astrocytoma
What is a high-grade astrocytoma?
High-grade astrocytomas are either grade 3 or grade 4 brain tumors. Both are malignant tumors, but grade 4 tumors are more aggressive than grade 3 tumors. These tumors most often occur in the cerebral hemispheres but can also occur in the thalamus or, less commonly, in the posterior fossa.
What causes cerebellar high-grade astrocytomas?
For the majority of cases we do not understand why children develop high-grade astrocytomas. There is nothing you could have done to prevent this from happening. There are certain genetic syndromes such as neurofibromatosis, tuberous sclerosis, and Li-Fraumeni syndrome that are associated with malignant astrocytomas, but for the majority of children these tumors occur without identifiable cause.
What is the outcome?
Unfortunately the outcome for children with malignant brain tumors remains poor. Children in whom the tumor could be surgically removed tend to have better outcomes than children with residual tumor or tumors that cannot be surgically removed because of their location in the brain.
What are the treatment options for high-grade astrocytomas?
Whenever possible, children with malignant astrocytomas undergo surgery followed by radiation therapy and some form of chemotherapy. External beam radiation therapy to the site where the tumor was removed has been shown to improve survival when compared to surgery alone, and it is therefore considered the standard of care. The thought is that radiation can kill cancer cells that may be left behind after the surgery. Children with high-grade astrocytomas are often treated in clinical trials since no effective treatment has yet been identified.
What is the treatment for recurrent or progressive high-grade astrocytomas?
Once there is evidence of tumor recurrence, there are several options available , including additional surgery, chemotherapy, and radiation. The best treatment for a child at the time of recurrence depends on several factors such as the location of the tumor, time from initial diagnosis, and prior treatment. A variety of clinical studies of experimental therapies are also available and your neuro-oncologist can discuss the different studies with you in detail.
What clinical trials are available for children with low-grade astrocytomas?
There are generally several trials available for children with progressive/recurrent high-grade gliomas. UCSF is part of the Pediatric Brain Tumor Consortium, which is a network of institutions funded by the National Cancer Institute that offers clinical trials of new therapies for children with brain tumors. We also partner with the Children’s Oncology Group and some industry sponsors to provide access to pediatric brain tumor clinical trials.
Click here for a list of trials for pediatric brain tumors currently offered at UCSF. Or contact Dennis Aguilling at (415) 476-9387 for additional information.
What research is being on high-grade astrocytomas?
The Brain Tumor Research Center at UCSF is dedicated to finding new, effective therapies for children with high-grade gliomas. Using pediatric tumor models in animals, we are currently investigating different drug-delivery systems and new therapeutic agents that inhibit the growth of these tumor cells. A subset of high-grade astrocytomas show specific cellular mutations and we are in the process of testing specific drugs for this specific group of tumors.