Low Grade Gliomas

The vast majority of low grade gliomas originate from the astrocytes. They are called "low grade" because they are tumours dividing slowly, have an indolent, chronic course and in general have a very good to excellent prognosis. When the surgeons completely remove the tumours there is no need for any other therapy (chemotherapy or radiation therapy) unless the tumour comes back which happens rarely. Incompletely resected tumours can be either followed with MRIs and treated if and when they start growing or treated without an "observation" period with chemotherapy or radiation, depending on the age, the location of the tumour and the symptoms of the child. Progressive low grade gliomas require either chemotherapy or radiation.

Several chemotherapy regimens (Temozolomide, Carboplatin and Vincristine, Vinblastine, TPCV) can be used for these tumours with reasonable success in controlling disease. The duration of chemotherapy is long (more than a year) and the primary aim is to delay the use of radiation therapy. In general, chemotherapy is well tolerated. Because radiation therapy has the potential of causing neuro-cognitive problems in very young children, it is generally avoided until an older age (around 10 years).