The Brain Tumor Program at St. Louis Children’s Hospital includes a dedicated team of pediatric neuro-oncologists, neurosurgeons, radiation oncologists and other specialists dedicated to diagnosing and treating pediatric brain tumors.
Brain tumor treatment requires skill and experience. No other hospital in the region has all of these services available for children with brain tumors — and the expertise to manage their treatment.
Brain Tumor Imaging
Before any treatment begins, it is vital that the patient receive an accurate diagnosis. To diagnose your child correctly, we will take a number of pictures of their brain using an MRI or CT scanner.
Our program partners with the Mallinckrodt Institute of Radiology, one of the leading radiology centers in the world, to ensure that your child’s scans are of the highest quality. We are developing transformative ways of imaging brain tumors and the brain itself, using novel tools and enhancements such as nuclear medicine amino acid tracers and functional MRI. These new agents provide a scope of tools that our team can use to provide the best possible outcome for your child.
Types of Pediatric Brain Tumor Treatment
At St. Louis Children’s Hospital, we use leading-edge technologies to perform effective, targeted procedures, removing as much of the tumor as possible while protecting healthy brain tissue.
We treat many brain tumors using some combination of surgery, chemotherapy and radiation. The treatments we use will depend on the type of tumor and its location, as well as your child’s individual needs, age, and health status.
Your child’s doctor and health care team will talk to you about any possible treatments. We will discuss the benefits and risks of any treatments so you understand your options.
Brain tumor surgery
The first step in treating most brain tumors is surgery. We remove as much of the brain tumor as we can. We often follow surgery with radiation and chemotherapy.
Siteman Kids at St. Louis Children’s Hospital is one of only a few facilities in the nation to provide intraoperative magnetic resonance imaging, or intraoperative MRI, for pediatric brain tumor patients. Intraoperative MRI lets our neurosurgeons see the brain in real time while they are operating. It is a major advance in the surgical treatment of pediatric brain tumors.
Intraoperative MRI surgeries take place in special operating rooms equipped with an MRI machine that can be guided seamlessly into place without disrupting the procedure. The surgeons will take repeated MRI scans as they operate. These images give the surgeons a more precise view of the tumor. This added precision can reduce the need for repeat surgeries.
MRI-guided Laser Heat Ablation (MLA)
MRI-guided Laser Heat Ablation is a minimally-invasive neurosurgical procedure that uses intense heat to destroy tumor tissue. It is FDA-approved and is currently available for some pediatric patients as an alternative to surgery. Crucially, it can provide hope in cases where the tumor is otherwise inoperable. It also has the potential to enhance other therapies that the patient is receiving.
Intensity modulated radiation therapy (IMRT)
Children with brain tumors often undergo radiation therapy as part of their treatment plan. At St. Louis Children’s Hospital, we offer a high-precision technique called intensity-modulated radiation therapy, or IMRT. During IMRT, small X-ray beams are aimed at the tumor from different directions. This can shrink tumors and even eliminate them completely.
IMRT is particularly useful for children with large tumors. It also helps reduce side effects by minimizing radiation exposure to healthy tissue. At Siteman Kids, we take CT scans and make a 3D model of the brain to ensure that the radiation beams are targeted exactly to the tumor.
Though radiation therapy is safe and effective, it can be anxiety-inducing for pediatric patients, who may need to be sedated before undergoing treatment. That’s why it’s crucial for children to receive radiation therapy at an experienced pediatric center that understands their unique needs and challenges. Our center has a full-time child life specialist who meets with children throughout treatment, easing anxiety and reducing the need for sedation. When sedation is needed, an experienced team of pediatric anesthesiologists from SLCH ensure the highest level of care for our patients.
Gamma Knife radiosurgery
When traditional surgery is not an option, we often use Gamma Knife radiosurgery. This minimally invasive treatment, a form of stereotactic radiosurgery, does not require any incisions. Gamma Knife lets us target tumors with ultra-precise amounts of radiation.
Proton beam therapy
This radiation treatment targets brain tumors with precise radiation. Proton therapy uses particles called protons — instead of the high-energy X-rays used in traditional radiation therapy — to deliver radiation to destroy cancer cells.
Because it is so precise, proton therapy allows providers to use higher doses of radiation than traditional radiation treatments. Very little radiation goes beyond the tumor, limiting damage to surrounding tissue and reducing side effects from radiation treatment.
Pediatric brain tumor patients at St. Louis Children’s Hospital undergo proton beam therapy at the S. Lee Kling Proton Therapy Center at Siteman Cancer Center. The Center offers intensity modulated proton therapy (IMPT), and, since 2013, has treated a high volume of pediatric brain tumors.
Many pediatric brain tumors are difficult to treat. They do not always respond to standard cancer treatments. When that happens, we have options.
We are always looking at new ways to treat brain tumors with clinical trials. We use trials to test new treatments to see if they work. Find out more about pediatric brain tumor research.
Follow-up care after treatment
From regular evaluations and checkups to rehabilitation and help with school, we continue supporting children and young adults after their treatment is over. Find out about our after care program.