The central nervous system (brain and spine) is the most frequent location of tumors in children. Tumors in this area of the body range from very slow growing and treatable with surgery or very fast growing, which can spread over the brain and spine. Some tumors may be very treatment sensitive and shrink away with very little chemotherapy or extremely resistant, growing despite radiation chemotherapy or biological treatments. These include:
Because tumors in the central nervous system can occur in such different ways, the first important step is finding out exactly what type of tumor your child has. In most situations this requires a neurosurgical operation. After surgery, the tumor tissue is analyzed by our neuropathology team so that we can determine a formal diagnosis. Depending on the diagnosis, we may recommend surgery or radiation, chemotherapy or biological therapy. Each of these treatment plans requires specialists, which have to work together smoothly in a productive team approach.
Pediatric tumors that recur after standard treatment are typically considered incurable. Recently, many novel targeted drugs with the potential for treating pediatric tumors have become commercially available. Most of these agents have been used for treatment of various malignancies in adults and have well-documented safety profiles, yet have not been introduced in the pediatric population. Because the numbers of pediatric patients with recurrent tumors are too small for typical standardized clinical trials, no data exist on the efficacy of these agents in the treatment of this patient population.
The team at Tufts Children's Hospital has developed a therapeutic algorithm merging published, evidence-based chemotherapy with novel drugs chosen individually based on the individual tumor biology. To accomplish this, the patient’s tumor is first analyzed for a panel of tissue markers, which are then used to select a target and a novel drug as inhibitor. The novel agent is then added to an evidence-based treatment backbone. At present, this kind of personalized therapy is used only for patient care and in informal nationwide collaborations.
We have been able to make advances in how we treat our patients because of our strong work in clinical research, which is an integral part of creating treatment plans for children with brain tumors. All families will be offered access to a variety of clinical studies to participate in. While some of these studies mainly help future patients, others provide access to new therapies and are used as clinical guidelines even when patients are not enrolled.
At Tufts Children's, most families have appreciated the participation and the clinical team enjoyed the support of the research team. In particular, we have found strong success using clinical trials in the treatment of high grade glioma, diffuse intrinsic pontine glioma, and choroid plexus tumors such as choroid plexus carcinoma or papilloma.
At Tufts Children's Hospital, the neuro-oncology team is lead by Laura Wiltsie, DO. The pediatric neurosurgical surgical team is led by Carl Heilman, MD who has specific expertise in pediatric neurosurgery and skull base tumors. Neuropathology is lead by Drs. Monika Piliochowska and Stephen Naber, who have specific expertise in tumor marker analysis. Pediatric radiation oncology is by John Mignano, MD who is also a specialist in gamma knife therapy.
If your child needs chemotherapy, it will be provided by our expert pediatric hematology/oncology team. Our nurse, Elisabeth Mobassaleh will work with your child to make him or her feel as comfortable as possible during this process. Our parent advisor, child life specialist and supporting social worker will also provide your family with outstanding resources and the tools you need to feel at home while your child is in our care.
Accepting New Patients
Virtual Appointments Available
Title(s): Neurosurgeon-in-Chief; Chairman of Neurosurgery; Professor, Tufts University School of Medicine
Appt. Phone: 617-636-5860
Fax #: 617-636-7587
Meningiomas, acoustic neuromas, skull base surgery, pituitary surgery, Chiari surgery
Title(s): Pediatric Hematologist/Oncologist; Assistant Professor, Tufts University School of Medicine
Department(s): Pediatrics, Hematology/Oncology
Appt. Phone: 617-636-5535
Fax #: 617-636-7738
Solid tumors, brain tumors
To make an appointment for your child to see our expert doctors, please call 617-636-5535.