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Low-Grade Glioma Treatment

A low-grade glioma (LGG) is a slow-growing tumor in the brain or spine. These tumors may affect the function of the brain or the body, depending on where they are located.

Pediatric low-grade gliomas are the most common central nervous system (CNS) tumors in children. They make up 30% of all childhood CNS tumors.

Types of low-grade gliomas

Types of low-grade gliomas include:

  • Angiocentric glioma
  • Astrocytoma, IDH mutant
  • Desmoplastic infantile astrocytoma
  • Desmoplastic infantile glioma
  • Diffuse astrocytoma, MYB or MYBL1 altered
  • Diffuse leptomeningeal glioneuronal tumor
  • Diffuse low-grade glioma, MAPK pathway altered
  • Dysembryoplastic neuroepithelial tumor (DNET)
  • Ganglioglioma
  • Hypothalamic glioma
  • Multinodular and vacuolating neuronal tumor
  • Optic pathway glioma
  • Oligodendroglioma
  • Papillary glioneuronal tumor
  • Pediatric type diffuse low grade glioma
  • Pilocytic astrocytoma
  • Pilomyxoid astrocytoma
  • Polymorphous low-grade neuroepitheal tumor of the young (PLNTY)
  • Rosette-forming glioneuronal tumor
  • Subependymal giant cell astrocytoma (SEGA)

Studies from St. Jude Children’s Research Hospital and other scientific institutions have found that almost all of these low-grade gliomas have specific molecular mutations, or errors, that occur in the tumor cells. For the most part, these mutations can be targeted with new specialized medicines called targeted therapies. This means that molecular testing must occur on the tumor to get the correct diagnosis and determine the best treatment.

Low-grade glioma symptoms

The symptoms of low-grade gliomas can vary and depend on the size of the tumor, where the tumor is, a child’s age, and how fast the tumor grows. The symptoms may include:

  • Vision, hearing, or speech problems
  • Headaches, especially in the early morning
  • Loss of balance or trouble walking
  • Weakness, tingling, or changes in the way the body feels on 1 side
  • Nausea and vomiting
  • Unexplained weight gain or loss
  • Seizures
  • Changes in personality or behavior
  • Increased head size (in infants)

Low-grade glioma causes

The cause of glioma tumors is unknown, but there are changes (mutations) in the DNA of some of the cells in the brain and spinal cord (central nervous system or CNS).

Low-grade glioma diagnosis

Diagnosis of low-grade gliomas generally includes:

  • Biopsy (obtaining tissue sample) of the tumor
  • Careful review of tissue sample under the microscope to make a diagnosis
  • Other genetic testing of the tumor to identify potential tumor targets
  • Imaging tests like magnetic resonance imaging (MRI), to check the size of the tumor and if it has spread to other areas

Gliomas are graded based on:

  • How the cells look under the microscope (features)
  • How quickly they are growing or dividing
  • The genetic changes that cause the tumor to develop

Grades 1 and 2 are low-grade gliomas that grow slowly.

Grades 3 and 4 are higher-grade gliomas that grow more quickly. These are usually not related to low-grade gliomas in children.

Treatment of low-grade glioma

The medical team is often made up of an oncologist, surgeon, and radiation oncologist, along with nurses and other care staff. They will discuss the types of treatment and help you decide on the best option for your child. The most common treatments are surgery, targeted therapy, chemotherapy, and radiation therapy.

  • Surgery is needed for diagnosis and treatment. For many low-grade gliomas, surgery can completely remove the tumor. This may help cure the disease. If all the tumor is removed or very little of the tumor remains after surgery, your child may be closely followed without other treatment and have follow-up MRIs to monitor the tumor and see if it grows again. If the tumor cannot be completely removed, or tumor re-growth is noted after surgery, then more therapy is generally needed.
  • Targeted therapies are changing the way we treat low-grade gliomas that cannot be completely removed. Recently, new medicines that specifically target tumor cells have caused tumor shrinkage with fewer side effects than traditional chemotherapy or radiation therapy. So, these targeted therapies are becoming our first choice of therapy in this disease.
  • Chemotherapy uses medicines that stops tumor and cancer cells from growing.
  • Radiation therapy using high-energy x-rays or other types of radiation, such as a proton beam (proton therapy), kill cancer cells or stop them from growing.

Low-grade glioma clinical trials

St. Jude clinical trials have produced new, groundbreaking treatments for serious childhood diseases. Our doctors and scientists work together to find better ways to treat patients. In many cases, new treatments are being developed right here on the St. Jude campus.

We also take part in trials developed by the Children’s Oncology Group (COG) and the Pediatric Brain Tumor Consortium (PBTC). Many St. Jude staff members play key roles in developing these studies. They are large studies carried out at multiple centers across the United States.

Learn more about clinical research at St. Jude.

HALGG: Hippocampal-Avoidance Using Proton Therapy in Children with Brain Tumors

Study goal:

The main purpose of this study is to find out what happens, good and bad, to memory and learning when the hippocampus is avoided during proton therapy radiation.


At least 6 years old and younger than 22

SJ901: Study of Mirdametinib as a Treatment for Children, Adolescents and Young Adults with Low-Grade Glioma

Study goal:

The main goal of this study is to test the experimental drug mirdametinib in hopes of finding a treatment that may be effective against low-grade glioma brain tumors in children, adolescents and young adults.


At least 2 years old and younger than 25 years old.

Low-grade glioma prognosis

Low-grade gliomas grow slowly and do not commonly spread (metastasize). But they may still cause many problems and need medical treatment. Survival rates for low-grade gliomas in children are good, with a 10-year survival rate greater than 85%. But the prognosis may vary and depends on:

  • The tumor’s specific type, location, genetic mutations, and grade
  • If the tumor was totally removed (resected)
  • If the tumor is just in 1 area or if it has spread
  • The child’s age
  • If the tumor was newly diagnosed or has returned (recurred)

Low-grade glioma care at St. Jude

St. Jude provides the highest quality of care for patients with low-grade glioma:

  • Our clinic brings together medical experts and specially trained staff to care for your child. We also work with brain surgeons (neurosurgeons) at Le Bonheur Children’s Hospital.
  • We have a special team that helps understand the makeup of the tumor. This team includes doctors and scientists who study:
    • Cancer cells
    • How the cancer happened
    • Current medicines and treatments to kill cancer cells
    • What makes cancer cells grow and what new medicines can stop them
  • New medicines and other therapies to improve how treatments work Our brain tumor clinical trials have led to better therapies in children. These improvements include lower-dose therapies, targeted therapy, and proton therapy. These treatments kill cancer cells while sparing healthy cells and may lessen side effects that affect brain function after treatment for some types of brain tumors.
  • The St. Jude Proton Therapy Center is the first center in the world that treats only children with this therapy.
  • Along with the treatment studies constantly being developed at St. Jude, the staff also treats patients on studies developed by the Children’s Oncology Group, the Pediatric Brain Tumor Consortium, and the Pacific Pediatric Neuro-Oncology Consortium. Many St. Jude staff members play key roles in developing these studies. They are large trials carried out at multiple centers across the United States. 
  • St. Jude offers a dedicated team of specialists to meet the needs of children with brain tumors, including:

More reasons to choose St. Jude for care include:

  • We are consistently ranked among the best childhood cancer centers in the nation by US News & World Report.
  • At St. Jude, we have created an environment where children can be children and families can be together.
  • We lead more clinical trials for childhood cancer than any other hospital in the U.S. 
  • St. Jude is the only National Cancer Institute–designated Comprehensive Cancer Center just for children. A Comprehensive Cancer Center meets rigorous standards for research that develops new and better approaches to prevent, diagnose, and treat cancer.
  • The nurse-to-patient ratio at St. Jude is about 1:3 in hematology and oncology and 1:1 in the Intensive Care Unit.
  • Patients may be able to get expert, compassionate care and treatment closer to their homes at one of our St. Jude Affiliate clinics.

Get more information about the Brain Tumor Treatment program at St. Jude.

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Seeking treatment at St. Jude

Patients accepted to St. Jude must have a disease we treat and must be referred by a physician or other qualified medical professional. We accept most patients based on their ability to enroll in an open clinical trial.

How to seek treatment

Contact us

You can start the referral process by letting your physician know you would like a second opinion from St. Jude. They can contact our 24-hour beeper service or contact our Brain Tumor Coordinator. You may also contact the brain tumor coordinator directly with questions.

Learn more about the types of brain tumors we treat at St. Jude, and our brain tumor eligibility requirements.

Physician / Patient Referral Office

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