Treatment of brain cancer in children
Among the symptomatic means of treating brain cancer in children are used: to reduce swelling of the brain tissue - corticosteroid drugs, for arresting attacks of muscle cramps - anticonvulsant drugs (anticonvulsants). All other methods of treatment are directed directly at the cancerous tumor. This is surgical removal of the neoplasm, radiation therapy and chemotherapy.
Chemotherapy is carried out by the introduction of special medications aimed at the destruction of cancer cells. These can be oral medications (in tablets or capsules), injections that are injected into a vein, muscle or artery, as well as into a cerebrospinal fluid. It should be noted that in most cases, chemotherapy is prescribed after surgical intervention or after irradiation.
Treatment of brain cancer in children is performed surgically by neurosurgeons of specialized clinics. To remove the tumor, craniotomy or trepanation of the skull necessary to access the brain is made, after which the maximum volume of cancer-affected tissues is excised, but so as not to affect the healthy parts of the brain and its important centers.
Radiation therapy or standard stereotactic radiotherapy of brain cancer in children involves external radioactive irradiation of the tumor. It should reduce the size of the tumor. And after the operation to remove the tumor - to prevent the growth of the remaining cancer cells in the brain.
Until recently, radiotherapy was the method of choice if it was impossible to get rid of brain cancer in an operative way. But now there is an alternative to surgical removal of the tumor - three-dimensional conformal radiation therapy (IMRT) and radiosurgery with the help of a cyber knife.
These non-invasive oncology technologies consist in the fact that the brain tumor undergoes the most accurately directed (due to computer detection and clear imaging of the tumor boundaries) and the optimal dose of radiation that kills cancer cells.
Chemotherapy for brain cancer in children
The main drugs that are currently used in chemical therapy for brain cancer in children include Carmustine, Temozolomide (Temodal), Lomustine, Vincristine, Bevacizumab (Avastin).
The antitumor drug Carmustine acts cytostatically, that is, it penetrates into cancer cells, reacts with their nucleotides, inhibits enzyme activity and disrupts DNA synthesis. Thus, mitosis (indirect division of cells) of the tumor ceases.
Treatment is carried out by a doctor who determines the dose based on the level of leukocytes and platelets in the blood plasma. Carmustine in the form of a solution is administered intravenously, an hour or two after its administration, there is hyperemia of the face (due to hot flashes), nausea and vomiting. Further, there are side effects of the drug, such as loss of appetite, diarrhea, difficult and painful urination, abdominal pain, changes in the blood (leukopenia, thrombocytopenia, anemia, acute leukemia), bleeding and hemorrhage, swelling, skin rash, ulcers oral mucosa, etc.
In the treatment of brain cancer in children with the help of Carmustine - like many other anti-cancer drugs-cytostatics - the likelihood of developing cumulative toxicity of the blood. Chemotherapy courses are held once every 6 weeks - to restore the hematopoietic function of the bone marrow. In addition, if this remedy for cancer has been used for a fairly long time, the probability of a "distant effect" in the form of the appearance of secondary cancers, including acute leukemia, is not ruled out.
Temozolomide (other trade names - Temodal, Temomide, Temtital) is available in capsules, operates on a similar principle and has almost the same side effects as Carmustine. The use in the treatment of brain cancer in children under the age of three is limited. The drug Lomustine is also intended for oral use. Selection of the dose for children and adults with brain tumors is carried out by the doctor individually and during the treatment is constantly adjusted - depending on the therapeutic effect, and also taking into account the severity of the intoxication. Side effects of Lomustin are the same as those of Carmustine.
Cytostatic drug for intravenous injections - Vincristine - is of vegetable origin and is an alkaloid of vinca pink. Dosage individually, but the average weekly dose for children is 1.5-2 mg per square meter. Meter body surface, and for children weighing up to 10 kg - 0.05 mg per kilogram of weight.
Side effects in the treatment of Vincristine are expressed in the form of increased or decreased blood pressure, seizures, headache, dyspnea, bronchospasm, weakening of muscle tone, sleep disorders, nausea, vomiting, stomatitis, intestinal obstruction, bladder atony and urinary retention, puffiness, etc. However The negative impact of Vincristine on the hemopoietic system is much less significant than that of the drugs mentioned above.
When relapsing glioblastoma - one of the most common forms of brain cancer in children and adults - an antitumor drug is administered in the form of a solution for the infusions of Bevacizumab (Avastin). This agent is a recombinant monoclonal antibody. It is capable of intervening in certain biochemical processes in the cells of a cancerous tumor, blocking its growth. Due to the low volume of distribution and the long half-life of Bevacizumab (Avastin) is used once for 2-3 weeks (intravenously and only drip). Among the side effects of Bevacizumab, there was an increase in blood pressure; perforation of the gastrointestinal tract; hemorrhage; rectal, pulmonary and nasal bleeding; arterial thromboembolism; leukopenia and thrombocytopenia; skin discoloration, increased lacrimation, etc. But all these side effects are not as intense as most drugs for drug treatment of brain cancer in children.