Pineoblastoma Treatment

Pineoblastoma is an aggressive tumor that starts in the pineal gland. This tumor makes up about 30% of pineal tumors in children.

Pineoblastoma is a type of embryonal tumor. It requires intensive therapy that includes surgery, radiation, and chemotherapy.

The cause of pineoblastoma is not known. New studies from scientists and doctors at St. Jude have found that instead of just 1 type of pineoblastoma, there are at least 4.

The treatment and prognosis of pineoblastoma depend on:

• If the tumor has spread
• Age of the child at diagnosis
• The type of pineoblastoma

Find out more about pineoblastoma on the Together by St. Jude™ online resource.

Types of pineoblastoma

There are multiple types of pineoblastomas based on the molecular or genetic changes (mutations) that caused the tumor to develop.

Because there are different types of pineoblastomas, molecular testing must occur on your child’s tumor to get the correct diagnosis and to determine the best treatment.

Types of pineoblastoma include:

• Pineoblastoma-miRNA1
• Pineoblastoma-miRNA2
• Pineoblastoma, FOXR2 activated
• Pineoblastoma, RB1 activated

Treatment of pineoblastoma

Pineoblastoma treatment focuses on safely removing as much of the tumor as possible with surgery, or with a combination of chemotherapy and surgery, followed by radiation and chemotherapy.

Treatment may include:

• Surgery to get a sample for diagnosis and to remove part or all of the tumor. In some cases, it is not possible to remove all of the tumor in 1 surgery. In these cases, we either perform a biopsy, use chemotherapy to shrink the tumor, or do both in order to help brain surgeons (neurosurgeons) later fully remove the tumor.
• Radiation is an important part of treatment for pineoblastoma. The dose, location, and timing of radiation will depend on many factors. These include your child’s age, type of tumor, and if it has spread to other parts of the brain or spine.
• Chemotherapy (chemo) is important in the treatment of pineoblastoma. The exact type of chemotherapy and the length of treatment will depend on your child’s age and type of pineoblastoma.

Pineoblastoma prognosis

The prognosis for pineoblastoma varies greatly. It depends on:

• The specific type and genetic mutations
• 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)

Pineoblastoma clinical trials

Patients with pineoblastoma take part in clinical trials that use the most advanced diagnosis tools and treatments available. Our goal is to give each child the best treatment with the lowest number of side effects.

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 of our doctors and scientists play key roles in developing these large studies. They happen at centers across the United States.

Learn more about clinical research at St. Jude.

Pineoblastoma care at St. Jude

St. Jude provides the highest quality of care for patients with pineoblastoma:

• We bring 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 better understand the makeup of the tumor. This team includes doctors and scientists who study:
  • What are the cells that have become cancerous?
    
  • How did this happen?
  • What medicines and treatments work to kill these cells?
  • What makes these cancer cells grow and what new medicines can be used to stop it?
  • How can we use new medicines along with other therapies to improve how treatments work?
• Our brain tumor clinical trials have led to the clinical use of better therapies in children such as lower-dose therapies, targeted therapy, and proton therapy. These treatments kill cancer cells while sparing healthy cells. They 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:
  • Surgeons, doctors, and nurses who treat this cancer
  • Doctors who specialize in radiation therapy and pathology (making a diagnosis by looking at tumor tissue under the microscope)
  • Experts in diagnostic imaging and nuclear medicine
  • Genetic counselors
  • Clinical dietitians
  • Child life specialists
  • Psychologists
  • Researchers and scientists

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 to develop 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 through the St. Jude Affiliate Program.

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

How to get brain tumor treatment at St. Jude

You can start the referral process by letting your doctor 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.