Astrocytoma Childhood

Childhood Astrocytoma

About the Central Nervous System (CNS):

The central nervous system (CNS), which includes the brain and spinal cord, controls some of the most important functions of the body, such as speech, thinking, and physical strength. Astrocytoma is a type of tumor that occurs when astrocytes, a type of cell found in the CNS, grow uncontrollably and form a mass.

Astrocytoma can occur anywhere in the CNS, but the most common locations include:

• The cerebellum: Controls balance and coordination.
• The cerebrum: Responsible for speech and voluntary muscle movements.
• The diencephalon: Controls vision, hormone production, and movement of limbs.
• The brain stem: Controls eye and face movements, limb movements, and breathing.
• The spinal cord: Controls the movement of muscles in the arms and legs, as well as sensations.

Statistics:

Astrocytoma is the most common brain tumor found in children. While exact data for India is not available, approximately 1,118 children are diagnosed with astrocytoma each year in the United States.

Risk Factors:

A risk factor is anything that increases the likelihood of developing cancer. Although risk factors may influence the chances of developing cancer, they do not directly cause it. The exact cause of brain tumors in children is not yet fully understood, but certain conditions may increase the risk of developing astrocytoma, including:

• Neurofibromatosis
• Other genetic conditions such as Li-Fraumeni syndrome, Tuberous sclerosis complex, Nevoid basal cell carcinoma syndrome, Turcot syndrome, and Constitutional mismatch repair deficiency syndrome (CMMRDS).

Symptoms of Childhood Astrocytoma:

• Headaches
• Fatigue or lethargy
• Seizures (without fever)
• Vision problems (such as double vision)
• Delays in growth
• In infants, the only sign may be an increase in head size.

Diagnosis:

• CT Scan: Imaging technique to detect abnormalities in the brain.

• MRI: Detailed imaging to identify tumor location and size.

• Biopsy: A sample of tissue is removed and examined under a microscope to confirm the presence of cancer.

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Grades of Astrocytoma:

• Low-grade tumor: The cancer cells look similar to healthy CNS cells and grow slowly. These tumors are less likely to spread to other parts of the brain. They rarely grow rapidly or metastasize.

• High-grade tumor: These tumors grow quickly and spread to various parts of the CNS. The cancer cells look very different from healthy CNS cells. Anaplastic astrocytoma is an example of a high-grade tumor.

• Recurrent astrocytoma: This refers to an astrocytoma that returns after treatment. The tumor often regrows in the same location where it originally appeared.

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Treatment for Childhood Astrocytoma:

1. Surgery:
• The primary treatment for astrocytoma is surgery, where the tumor and a small margin of healthy tissue surrounding it are removed. In some cases, especially with low-grade tumors that grow in hard-to-reach areas, doctors may recommend closely monitoring the tumor for months before proceeding with surgery.
• If the tumor cannot be fully removed through surgery, or if it is a high-grade tumor, additional treatments such as radiation or chemotherapy may be required.
2. Radiation Therapy:
• High-energy radiation is used to destroy cancer cells. Radiation therapy may affect a child’s brain development, so alternative treatments are often recommended first, especially for younger children.
3. Chemotherapy:
• Chemotherapy can be used instead of radiation for low-grade tumors. In high-grade tumors, chemotherapy is often used in combination with surgery and radiation therapy. The side effects of chemotherapy may include fatigue, nausea, vomiting, infection risk, hair loss, loss of appetite, and diarrhea.
4. Targeted Therapy:
• Larotrectinib is a drug used in targeted therapy, but it is only employed in specific cases.
5. Immunotherapy:
• Research is ongoing to determine how immunotherapy can be used to treat astrocytoma.

Follow-up for Astrocytoma:

After treatment, regular follow

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