Glioblastoma multiforme (GBM) is a high-grade glioma that arises from the brain’s supportive tissue, known as glial cells. It is an aggressive tumor that rapidly affects nearby healthy brain tissue. GBM is challenging to treat.
- Approximately 65 percent of GBM cases appear in the cerebral hemispheres, which control higher functions like speech, movement, thought, and sensation.
- They can also develop in other parts of the brain that identify sensations such as temperature or that control balance and motor function.
- Diagnosis typically happens in children between five and nine years old. GBM occurs in boys and girls equally.
- GBM develops more often in children with specific genetic syndromes, such as neurofibromatosis 1 (NF1), Li-Fraumeni syndrome,
hereditary nonpolyposis colon cancer, and tuberous sclerosis. However, most GBM cases have no known cause.
At Dana-Farber/Boston Children's Cancer and Blood Disorders Center, we treat children with GBM through our Childhood Glioma Program, which is
part of our Brain Tumor Center. Children receive expert care from a team of pediatric brain cancer specialists with expertise in treating GBM.
Symptoms of Childhood GBM
Most GBM symptoms result from increased pressure within the head. Other symptoms arise from the tumor's specific location, growth rate, and associated inflammation.
Symptoms can develop slowly over time or begin very suddenly. The most common symptoms include:
- Headache and lethargy (generally upon awakening in the morning).
- Seizures, depending on tumor type and location.
- Compression of surrounding brain structures. Depending on the location, this can cause weakness and other motor dysfunction, hormonal abnormalities, or changes in behavior or thought processes.
How We Diagnose Childhood GBM
Doctors typically use imaging studies and biopsy (tissue sample) to form an accurate and complete diagnosis of GBM.
After completing all necessary tests, our experts meet to review and discuss what they have learned about your child's condition. Your child’s doctor will meet with you and your family to discuss the results and outline the best possible treatment options.
How We Treat Childhood GBM
GBM treatments may include:
- Surgery: The first treatment is usually surgery to remove as much of the tumor as possible. We use advanced techniques to maximize tumor removal, such as intraoperative MRI (in which surgeons can visualize the tumor as they operate). It is challenging
to completely remove most high-grade gliomas because they tend to affect nearby healthy tissues.
- Radiation therapy: We use high-energy waves from a specialized machine to damage or shrink tumors. Your child also may receive precisely targeted and dosed radiation to eliminate any cancer
cells left behind after surgery. Radiation therapy can help control the local growth, which can increase survival in high-grade gliomas.
- Chemotherapy: We may use chemotherapy, a drug treatment that aims to destroy or shrink cancer cells, before surgery to help shrink the tumor. However, chemotherapy hasn’t been shown to increase survival
rates in children with GBM.
Unfortunately, the prognosis for children with GBM is poor. Our Pediatric Advanced Care Team (PACT) offers supportive treatments that help children’s quality of life and promote comfort and healing.
Beyond PACT, the Stop & Shop Family Pediatric Neuro-Oncology Outcomes Clinic for pediatric brain tumor survivors provides access to same-day follow-up visits
with your child’s care team and access to support specialists, including speech, physical, occupational, and integrative therapy specialists.
Research and Clinical Trials for Childhood GBM
For many children with brain tumors or other rare or hard-to-treat conditions, clinical trials provide new options.
In addition to launching our own clinical trials, we also offer trials available through collaborative groups such as the Children's Oncology Group (COG). If your child has progressive or recurrent tumor, she may
be eligible for a number of clinical trials.
Scientists at Dana-Farber/Boston Children’s are conducting numerous research studies to help clinicians better understand and treat GBM and other malignant gliomas. Through the consortia of researchers to which we belong, a number of novel therapies are
available for children with both newly diagnosed and current brain tumors.
Participation in any clinical trial is completely voluntary. We will take care to fully explain all elements of the treatment plan prior to the start of the trial, and you may remove your child from the medical study at any time. If you have any questions
about clinical trials, your child’s doctor can provide you with additional information.
Long-term Outcomes for Children with GBM
The prognosis for GBM is poor, but survival rates may increase when surgery can remove most of the tumor. Your child’s doctor will discuss treatment options with you, including clinical trials and supportive care.
Childhood Glioblastoma Multiforme Treatment Team
Our glioma treatment team includes specialists with extensive experience treating children with glioblastoma multiforme. See a complete list of the specialists in our Childhood Brain Tumor