For most pineal parenchymal tumors, the first treatment is surgery, although radiation therapy may be the primary treatment for adults and children over the age of three. For pineocytoma cases, the standard treatment is surgery plus radiation therapy; for pineoblastoma cases, surgery plus radiation therapy and chemotherapy is often used. In very young patients whose bodies cannot handle radiation therapy, chemotherapy may be used as a delay tactic. In addition, a shunt may be needed to treat hydrocephalus, which is caused by a blockage of the arteries.
In cases of high-grade pineoblastoma, treatment options usually involve radiation to the brain and spine to slow the cancer’s progression through the cerebrospinal fluid.