This week's artwork was donated by Jaclyn, a pediatric cancer patient who received treatment at The Children's Hospital of Philadelphia . Diffuse intrinsic brain stem gliomas Conventional treatment for children with diffuse intrinsic brain stem glioma is radiation therapy to involved areas. The conventional dose of radiation therapy ranges between 5400 cGy and 6000 cGy given locally to the primary tumor site in single daily fractions. The role of chemotherapy in the treatment of patients with newly diagnosed brain stem gliomas is limited. To date neither adjuvant or neoadjuvant chemotherapy nor immunotherapy when added to radiation therapy has been demonstrated to improve survival for children with diffuse intrinsic tumors.
Studies using chemotherapy with radiation are ongoing.
Children younger than 3 years of age with diffuse intrinsic tumors may benefit from chemotherapy to delay or modify radiation therapy. Patients with small tectal lesions and hydrocephalus but no other neurological deficits may be treated with cerebrospinal fluid diversion and have follow-up with sequential neuroradiographic studies until there is evidence of progressive disease. I and brain stem gliomas may have a different prognosis than other patients who have intrinsic lesions. Freeman CR, Krischer JP, Sanford RA, et al. Mandell LR, Kadota R, Freeman C, et al.