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The Memorial Sloan-Kettering Childhood Brain Tumor group participates in national trials through the Children's Oncology Group, but we also offer many treatment protocols unique to Memorial Sloan-Kettering. For pediatric patients with brain tumors, institutional studies currently include protocols using:
- A procedure that uses high-dose chemotherapy with autologous stem cell rescue for appropriate patients with recurrent brain tumors (including medulloblastoma, PNET, and germ cell tumors).
- For children with newly diagnosed medulloblastoma, there are ongoing clinical protocols that use a new treatment called radioimmunotherapy. In this therapy, a radioactive substance is linked to an antibody that will attach to the tumor when injected into the body. Radioimmunotherapy is used in conjunction with a decreased radiation dose (in an attempt to reduce side effects) and conventional chemotherapy.
- For patients with recurrent tumors that have spread along the surface of the brain and/or spinal cord (a condition known as leptomeningeal disease), they may be eligible for a protocol using a substance known as an intrathecal monoclonal antibody (in this case called 3F8) that is attached to a radioactive form of iodine. The idea is to deliver targeted radiation to the tumor cells, while the normal surrounding structures, which are not targeted, receive very little radiation.
- A radiation oncology treatment called IMRT (intensity modulated radiation therapy) that more tightly focuses the radiation on the tumor, paired with immunotherapy, is being used for most of our patients to reduce the side effects related to radiation therapy like cognitive changes, hearing loss and/or hormonal changes. By reducing the dose of radiation to normal brain tissue, we expect that the risk of these side effects will be reduced. In addition, our doctors have expertise in various forms of radiosurgery -- in this process, which uses precise (stereotactic) positioning, computer guidance using MRI scans, and other modern technology, the radiation oncologist can deliver high-dose radiation treatments to tumors anywhere in the brain.
- Also available are sophisticated new radiology services such as PET scanning (a highly sensitive technology that picks up the metabolic signal of actively growing cancer cells in the body) and functional MRI scanning (a diagnostic test that indicates areas of increased brain function activity corresponding to specific tasks the patient is asked to perform, allowing the surgery to be planned to avoid these areas). We also use MR Spectroscopy, a non-invasive diagnostic test that identifies the chemical composition of tumors and can aid in diagnosis and prognosis.
