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About Childhood Low-Grade Gliomas

  • Low-grade gliomas are brain tumors that originate from glial cells, which support and nourish neurons in the brain. Glial tumors, or gliomas, are divided into four grades, depending on the cells' appearance under a microscope.

    • Grade 1 and 2 gliomas are considered low-grade and account for about two-thirds of all pediatric tumors.
    • Low-grade gliomas are also classified based on their location and by the kind of glial cell – astrocytes, oligodendrocytes or ependymocytes – from which they arise.
    • Most low-grade gliomas are both highly treatable and highly curable.
    • The most common kind of low-grade glioma is pilocytic astrocytoma. It has a cure rate of over 90 percent.

    At Dana-Farber/Boston Children's Cancer and Blood Disorders Center, we provide expert care to children with low-grade gliomas in our Childhood Glioma Program, a part of our comprehensive Brain Tumor Center.

    Our glioma team includes specialists in neuro-oncology, surgery, pathology and radiation oncology. They come together to give every child the very best and most compassionate care possible.

    Symptoms of Childhood Low-Grade Glioma

    Low-grade gliomas are slow-growing tumors. As they grow, they press on surrounding healthy parts of the brain, affecting their function. Low-grade glioma symptoms depend on the tumor's size and location in the brain.

    Some of the most common symptoms of pediatric gliomas include:

    • Headache, particularly in the morning or made better by vomiting
    • Severe or frequent vomiting without other signs of gastrointestinal illness
    • Vision problems, such as double vision, blurry vision, or loss of vision
    • Difficulty walking or balancing
    • Seizures
    • Weight gain or loss
    • Premature puberty
    • Clumsiness
    • Confusion
    • Sleepiness
    • Changes in behavior

    How We Diagnose Childhood Low-Grade Glioma

    Our doctors take the first step in treating your child by reviewing your child’s medical history and performing physical and neurological exams. Your doctor may also order various diagnostic tests to form a complete diagnosis. Testing may include imaging studies, biopsy, EEG, and lumbar puncture.

    After the medical team completes all tests, your child’s doctor will discuss the results and most effective treatment options with your family.

    How We Treat Childhood Low-Grade Glioma

    We personalize each child’s treatment based on the tumor’s type, stage, and location. While some therapies will treat the tumor, we may use others to manage disease complications or treatment side effects.

    Treatment may include:

    • Surgery: Surgery may involve removing as much of the tumor as possible.
    • Chemotherapy: We may use chemotherapy, a drug treatment that aims to destroy or shrink cancer cells, either before or after treatment.
    • Radiation therapy: We only use radiation if it’s appropriate for the type of glioma. Most often, we recommend it for high-grade gliomas.
    • Targeted therapy: Targeted therapy, also called precision medicine, works by tailoring treatment to the genetic characteristics of the cancer in an individual child.

    We offer extensive support before, during, and after treatment. Once treatment is complete, we continue to care for children and their families through our pediatric cancer survivorship programs, including the Stop & Shop Family Pediatric Neuro-Oncology Outcomes Clinic for pediatric brain tumor survivors. These services address health and social issues, ranging from motor function evaluation and physical therapy to return-to-school and learning programs.

    Research and Clinical Trials for Childhood Low-Grade Glioma

    Research is a top priority at Dana-Farber/Boston Children's. Our physicians work continuously to translate laboratory findings into clinical therapies and find ways to improve survival while reducing the toxicity and long-term impact of treatment.

    Our Pediatric Low-Grade Astrocytoma (PLGA) Program is the world's only multidisciplinary clinical and research program for pediatric low-grade gliomas. Established in 2007 with support from the PLGA Foundation, the program looks for more effective, less toxic treatments and a cure for children battling brain tumors.

    Our pediatric neuro-oncologists are actively contributing to these efforts. The program has contributed to international research efforts that have identified genomic drivers contributing to the growth of low-grade gliomas. Specifically, we have identified genes that commonly mutate into low-grade gliomas. These findings are guiding clinical trials examining the activity of new drugs specifically for children with low-grade glioma.

    We are testing new types of low-grade glioma treatment through clinical trials. If you have any questions about clinical trials, your child’s medical team is here for you.

    Long-term Outcomes for Children with Low-Grade Gliomas

    Each child’s chance of recovery depends on factors including tumor type, size, location, and extent of the disease. However, in most cases, low-grade gliomas are highly treatable. Prompt medical attention and appropriate therapy are essential for the best prognosis.

    Childhood Low-Grade Glioma Treatment Team

    We bring together an expert team of pediatric neurology specialists to treat children with low-grade gliomas. See a complete list of the specialists in our Childhood Brain Tumor Center.