Patients come from around the world come to Cincinnati Children’s for expert treatment for brain tumors in children or young adults. Some patients are newly diagnosed and others seek care for recurrent or treatment-resistant tumors.
Conditions we treat include:
- Gliomas. The most common type of brain tumor is glioma. These tumors begin from “glial” cells, which support functions of the nervous system. There are two major groups of glioma:
- High-grade gliomas
- Low-grade gliomas
Examples of gliomas include:
- Astrocytomas, which typically occur in the cerebellum, the area of the brain that plays a role in almost all of the body’s physical movement.
- Ependymomas, which usually begin in the lining of the ventricles (large open structures deep in the brain) or in the spinal cord, near the cerebellum.
- Optic nerve gliomas, which usually start in the optic nerve. They can cause vision issues and other problems.
- Diffuse midline glioma (DMG), formerly known as diffuse intrinsic pontine glioma (DIPG).
- Embryonal tumors. These can include:
- Atypical teratoid rhabdoid tumor (ATRT) is a rare and aggressive type of cancer that can appear in the brain or spinal cord.
- Medulloblastoma, which commonly occurs in the cerebellum and blocks cerebrospinal fluid from draining, causing increased pressure in the brain. Medulloblastoma to be considered a type of Primitive Neuroectodermal Tumors (PNET), but that term isn’t used anymore.
- Craniopharyngiomas, which arise above the pituitary gland, a pea-sized structure attached to the base of the brain that helps control the body’s growth, development and regulation.
- Germ cell tumors of the brain include germinoma, teratoma, embryonal carcinoma and yolk-sac tumors. These typically occur in the first two years of life but can occur later.
- Choroid plexus tumors, which arise from cells lining the ventricles of the brain.
- Tumors associated with neurofibromatosis (type 1 and type 2) and schwannomatosis treated in partnership with the Neurofibromatosis Program
- Meningeal tumors, such as meningioma, which arise from the membranes (meninges) surrounding the brain and spinal cord.
- Mixed neuronal-glial tumors, which have abnormal neuron cells and abnormal glial cells. Examples include those listed below.
- Ganglioglioma are usually small and noncancerous and develop slowly.
- Subependymal giant cell tumors may occur in children and adults who have a condition called tuberous sclerosis.
- Pleomorphic xanthoastrocytoma often occur between 10 and 20 years of age. They can be cancerous or noncancerous and may spread to other parts of the brain and spine.
Innovative and Advanced Therapies for Brain Tumors
Our care team creates a personalized treatment plan for each patient. The plan may include chemotherapy, novel immune therapies, radiation therapy, surgery to remove some or all of the tumor(s), and blood or marrow transplantation. Patients have access to both national clinical research studies as well as research studies only available at Cincinnati Children’s.
Chemotherapy
Chemotherapy uses one or more anti-cancer drugs to destroy cancer cells or slow down their growth. The care team customizes the chemotherapy regimen based on each patient’s diagnosis and needs. Many new drugs target specific changes (mutations) in tumors, or activate the immune system to kill cancer cells and reduce chemotherapy side effects. Sometimes, experimental chemotherapy offers the most promise for a cure. In these cases, we partner with national research organizations and drug companies to bring these therapies to our patients.
Precision Radiation Therapy
Our leading-edge radiation therapies deliver high doses of radiation while sparing healthy tissue. They include:
- Proton therapy is one of the most precise and advanced forms of radiation therapy available in the world today. In the hands of the expert cancer team at Cincinnati Children’s, specialized pencil beam technology destroys cancer cells while minimizing damage to surrounding healthy tissues and organs. Our Proton Therapy Center is one of only two such centers in the world owned by a children’s hospital.
- Shaped-beam stereotactic radiation therapy delivers high doses of radiation using custom-shaped beams to difficult-to-reach areas.
- Intensity-modulated radiation therapy allows physicians to modulate the intensity of radiation beams and deliver radiation that conforms to the tumor’s shape.
Advanced Surgical Procedures in the BrainSUITE
The BrainSUITE is an operating room with highly specialized equipment that helps surgeons be more precise in locating and removing brain tumors. This can preserve areas of the brain that control important functions, such as speech and movement. Cincinnati Children’s was the first children’s hospital in the world to use this system.
During surgeries on the brain, computer-generated images automatically match information from diagnostic tests with the patient’s position on the operating table. This allows the neurosurgeon to see the exact position of the surgical instruments in relation to the targeted brain tissue.
Bone Marrow Transplantation
Our Bone Marrow Transplantation Program team has performed more than 2,300 bone marrow transplants, making us one of the most experienced pediatric transplant programs in the world. We are an international leader in the development of new transplant regimens for patients with leukemia, lymphoma and myelodysplasia.
Our bone marrow transplantation team specializes in innovative approaches to transplant therapy. The team:
- Has developed transplant procedures that are now the standard of care in 240+ cancer centers throughout North America
- Has performed transplants on more than 100 children a year, with a 96% survival rate—significantly higher than the national average
- Has extensive experience in performing complex stem cell transplants from unrelated donors
- Utilizes reduced-intensity preparative regimens, which offer lower doses of chemotherapy with the potential for fewer side effects
- Pioneered new applications for bone marrow transplant, such as transplant for autoimmune lymphoproliferative syndrome
Novel Immunotherapies and Targeted Antibody Therapies
When a tumor of the brain or spine does not respond to treatment or returns following treatment, the care team may develop a new strategy involving innovative therapies including immunotherapies and targeted antibody therapies.
Immunotherapy is designed to help the body’s own immune system fight cancer cells. Targeted antibodies therapies are drugs that bind to antibodies found on cancer cells. This “tags” the mutations or markers on cancer cells so that the immune system can better recognize and destroy them.
Our Team-Based Approach for Care
Your child will receive expert care from a dedicated team that includes a pediatric neuro-oncologist (physician who specializes in brain and spine tumors), nurse practitioner and neuro-oncology care manager. Depending upon your child’s needs, the team will expand to include others, including pediatric care specialists in:
- Neurology
- Neurosurgery
- Radiation oncology
- Bone marrow transplantation
- Endocrinology (growth and hormone specialist)
- Genetics
- Neuro-ophthalmology (for visual problems related to the nervous system)
- Pathology (laboratory services)
- Psychology
- Rehabilitation therapy specialists
Comprehensive Care Coordination
Your child’s neuro-oncology care managers are nurses who will serve as your family’s point person. You can depend on your care manager to schedule your child’s clinic appointments and medical tests, follow-up on lab results, provide extensive education about your child’s condition and care, plan for a smooth transition back home after a hospital stay, coordinate your child’s participation in research studies, answer questions between clinic appointments and provide emotional support.
Caring providers stand ready to offer additional support − and you don’t even have to ask. Services can include:
- Child life therapy
- Pain management
- Psychological care
- Holistic therapies, such as massage therapy, reflexology and yoga
- Physical and occupational therapy
- Music therapy
- Nutrition
