Astrocytoma is a type of glioma, which is a brain tumor that arises from brain tissue. Astrocytomas resemble astrocytes, the supportive cells that surround and protect the nerve cells (neurons) in the brain. Some astrocytomas grow slowly; others are aggressive. The most aggressive form is glioblastoma, which remains challenging to treat and requires a multimodal plan.
At UPMC, our neurosurgeons will perform a comprehensive evaluation and recommend a personalized plan designed to maximize tumor control and protect brain function. Care is coordinated through multidisciplinary tumor boards with neurosurgery, neuro-oncology, radiation oncology, neuropathology, neuroradiology, rehabilitation and supportive care.
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What Is an Astrocytoma?
Astrocytomas are gliomas that look and behave like astrocytes. Our modern integrated diagnosis blends what the tumor looks like under the microscope with its molecular genetics to help guide prognosis and treatment options.
What are the types of astrocytomas?
The 2021 WHO Classification of CNS tumors organizes diffuse gliomas mainly by IDH mutation and 1p/19q codeletion status:
- Astrocytoma, IDH-mutant (adult-type) — Graded 2, 3, or 4.
- Glioblastoma, IDH-wildtype (adult-type) — Always grade 4.
- Pediatric-type astrocytomas include pilocytic astrocytoma, pleomorphic xanthoastrocytoma, and others.
Circumscribed (grade 1) astrocytomas include pilocytic astrocytoma, pleomorphic xanthoastrocytoma, and subependymal giant cell astrocytoma, which are often curable with surgery.
How common is astrocytoma?
In U.S. children, pilocytic astrocytoma is the most common brain tumor. The incidence is about 14 new cases per million children under age 15 in the U.S. each year.
In adults, glioblastoma is the most common malignant primary brain tumor. The incidence is about 3.19 cases per 100,000 population of U.S. adults, with 1.6 times higher incidence in males than females, and a 2.0 times higher incidence among white people compared with Black, Asian, or native American populations.
What causes astrocytomas?
Most astrocytomas arise sporadically for reasons researchers don't fully understand.
Astrocytoma risk factors
You may be at increased risk of developing an astrocytoma if you have:
- Radiation exposure — Previous ionizing radiation, especially in childhood, is a strong risk factor.
- Genetic syndromes — NF1, tuberous sclerosis, Li-Fraumeni syndrome, Turcot syndrome, mismatch repair deficiency.
- Environmental/genetic changes — MAPK pathway mutations, PTEN, KRAS alterations.
Multifactorial contributors, including
How can I prevent astrocytoma?
No definitive lifestyle or environmental preventive strategies have been established specifically for astrocytomas. Avoiding unnecessary radiation exposure and maintaining general healthy lifestyle habits, such as avoiding smoking, exercising regularly, and eating a balanced diet, are advisable for overall reduction of cancer risk.
What Are the Signs and Symptoms of Astrocytoma?
Astrocytoma symptoms may include:
- Headaches, seizures, and/or nausea and vomiting.
- Personality or behavior changes.
- Weakness, numbness, or memory or speech problems.
When should I see a doctor about my astrocytoma symptoms?
If you have symptoms of astrocytoma, you should schedule an appointment with your doctor right away. If you have a seizure or other severe symptoms, you should dial 911 or go to the nearest hospital Emergency Department.
How Do You Diagnose Astrocytoma?
Diagnosis includes MRI (with advanced sequences), biopsy/resection, and molecular testing (IDH, ATRX, TP53, 1p/19q, MGMT). Amino-acid PET may help in some cases.
Prognosis depends on tumor type, molecular profile, location, and extent of resection.
What to expect during your visit
If your doctor suspects an astrocytoma, they will:
- Ask about your symptoms.
- Perform a physical and neurological exam.
- Order imaging tests.
- Review your health history and medications.
Tests to diagnose astrocytoma
Your doctor may order imaging studies, including:
- Magnetic resonance imaging (MRI) — A test that uses a magnetic field and radio waves to pinpoint the location of the tumor and help doctors determine its size.
- MRI (with advanced sequences).
- Biopsy/resection.
- Molecular testing (IDH, ATRX, TP53, 1p/19q, MGMT).
- Amino-acid PET scan.
Astrocytoma prognosis
Prognosis depends on tumor type, molecular profile, location, and extent of resection. Your doctor will discuss your prognosis with you.
How Do You Treat Astrocytoma?
Our neurosurgical team at UPMC may use a combination of surgical and nonsurgical approaches to treat astrocytoma.
The most common treatment approach for astrocytoma is surgery or biopsy, followed by radiation therapy and chemotherapy.
Treatment is individualized and may include:
Surgery for astrocytoma
Whenever possible, neurosurgeons will surgically remove the astrocytoma.
Neuroendoport® surgery
Neuroendoport surgery offers a minimally invasive option for tumors within the ventricles (fluid spaces) or deep-seated tumors within the brain.
A narrow tube or port allows surgeons to access these tumors through a tiny incision in your scalp — offering a minimally invasive alternative to traditional brain surgery.
It offers:
- Maximal safe resection.
- Awake mapping.
- 5-ALA fluorescence-guided surgery.
Laser thermal ablation
Laser interstitial thermal therapy (LITT) is a minimally invasive procedure that uses heat generated by a laser at the tip of a very thin probe to ablate the tumor or abnormal tissue through an incision about the width of a pencil eraser.
Gamma Knife radiosurgery
Gamma Knife radiosurgery is a painless procedure that uses hundreds of highly focused radiation beams to target brain tumors and lesions, with no surgical incision.
For astrocytomas, our neurosurgeons may use a Gamma Knife boost to treat recurrent or residual tumors.
As the nation's leading provider of Gamma Knife procedures, UPMC has treated nearly 20,000 patients with tumors, vascular malformations, pain, and other neurological problems.
Neurosurgeons may also perform stereotactic radiosurgery using the Cyberknife and other linear accelerator-based systems.
Radiation therapy
Fractionated external beam radiation therapy (EBRT) is a common treatment for brain tumors, either alone or in combination with surgery and/or chemotherapy.
Doctors may also use radiation therapy internally by placing radioactive material directly in the body near the cancer.
Chemotherapy
Chemotherapy uses drugs to stop the growth of cancer cells. Depending on the type and stage of brain cancer, chemotherapy may be taken by mouth, injected, or placed directly into the brain tumor.
Typical protocols for treatment of astrocytomas include:
- Adjuvant temozolomide in IDH-mutant anaplastic astrocytoma.
- Lomustine + temozolomide in MGMT-methylated glioblastoma.
- Temozolomide (with radiation in glioblastoma).
Tumor treating fields (TTFields), which are:
- FDA-approved, used with temozolomide in glioblastoma.
Targeted therapies include:
- Dabrafenib + trametinib (BRAF V600E pLGG).
- Vorasidenib (IDH-mutant grade 2 gliomas, FDA approved in 2024).
- Tovorafenib (OJEMDA(TM), BRAF-altered pediatric gliomas, FDA approved in 2024).
In addition, clinical trials and immunotherapy are available for eligible patients.
Why Choose UPMC for Astrocytoma Care?
When you choose UPMC for astrocytoma care, you will receive:
- Access to world-class neurosurgery expertise — Our world-renowned experts treat the full spectrum of neurological and cancer conditions using the latest diagnostic and treatment techniques. These include minimally invasive Neuroendoport(R) expertise, world-leading Gamma Knife(R) radiosurgery program, integrated molecularly informed care, and broad access to clinical trials and novel targeted therapies.
- A full range of treatment options — We offer nonsurgical care and noninvasive, minimally invasive, and traditional open surgical procedures. This allows us to effectively treat all types of disorders while reducing your risk of complications.
- Multidisciplinary care — Our neurosurgeons partner with neurologists, medical oncologists, radiologists, rehabilitation specialists, and other medical experts to provide complete care that optimizes your recovery and quality of life.
