Adjuvant Therapies for Cerebellar Astrocytomas in Children

After gross total surgical resection, adjuvant therapy is not indicated.  In general, reoperation is favored over either radiation therapy or chemotherapy for recurrent disease that is resectable.

Chemotherapy

• Rarely used: Chemotherapy is an option for recurrent, unresectable cerebellar astrocytomas but is rarely necessary to consider. Malignant cerebellar astrocytomas are exceedingly rare and are treated with postoperative radiation therapy and chemotherapy (14).

Radiation

• Used for unresectable and/or recurrent tumors: Either focal conformal radiation therapy or stereotactic radiosurgery may be considered for unresectable residual or recurrent tumor that progresses on serial imaging studies (1, 5).