Gliomas

Gliomas

These account for more than half of brain tumours in children and are located preferentially in the cerebral cortex and its deep structures (optic channel, thalamus, floor of the fourth ventricle).

Unlike adults, most of them are of benign histology, so compatible with a prolonged survival, of the order of 80%, where the quality of life is paramount. A notable exception is malignant brainstem gliomas, which are usually very aggressive, for which radiotherapy has a predominantly symptomatic effect.
In deep benign forms, cystic and/or solid in imaging, which may be of considerable size, radiotherapy is often used as first-line therapy in the older child, or in the younger child after prolonged evaluation of the efficacy of chemotherapy.

The position of proton therapy

This is the therapy of choice for benign forms. There is much work on dosimetry from aboard suggesting a substantial reduction in toxicity to sensory organs, hormonal secretions and perhaps an improvement in intellectual performance.

Schedule of irradiation

Benign forms: daily sessions, spread over approximately 5 to 6 weeks
Malignant forms: daily sessions, spread over approximately 3 to 6 weeks