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/Home/Brain Tumors: Treatment
A variety of therapies are used to treat brain tumors. The type of treatment recommended depends on the size and type of the tumor, its growth rate, and the general health of the patient. Treatment options include surgery, radiation therapy, and chemotherapy, or a combination of these. Surgical resection (if safe) is generally the first treatment recommendation to reduce pressure in the brain rapidly. This Web site focuses on radiation therapy for brain tumors.
In the past two decades, researchers have developed new techniques of delivering radiation that target the brain tumor while protecting nearby healthy tissues. These treatments include brachytherapy, intensity-modulated radiation therapy (IMRT) and radiosurgery.
Radiation therapy may be advised for tumors that are sensitive to this treatment. Conventional radiation therapy uses external beams of x-rays, gamma rays, or protons aimed at the tumor to kill cancer cells and shrink brain tumors. The therapy is usually given over a period of several weeks. Whole brain radiation therapy is an option in the case of multiple tumors.
New types of radiation therapy include:
Brachytherapy: the temporary placement of radioactive materials within the body, usually employed to give an extra dose—or boost—of radiation to the area of the excision site. See the Brachytherapy page for more information. Brachytherapy is used on rare occasions.
Hyperfractionation involves smaller doses of radiation two to three times a day, as opposed to a larger amount once a day.
Stereotactic radiosurgery is a highly precise form of radiation therapy that directs narrow beams of radiation to the tumor from different angles. For this procedure, the patient wears a rigid head frame. Computed tomography (CT) or magnetic resonance imaging (MRI) help the doctor identify the tumor's exact location and a computer helps the doctor regulate the dose of radiation. See Stereotactic radiosurgery page. Stereotactic radiotherapy is similar physically to radiosurgery but involves fractionation (multiple treatments). This modality would be recommended for tumors within or close to critical structures in the brain that can not tolerate a large single dose of radiation (radiosurgery).
Intensity-modulated radiation therapy (IMRT): an advanced mode of high-precision radiotherapy that utilizes computer-controlled x-ray accelerators to deliver precise radiation doses to a malignant tumor or specific areas within the tumor. The radiation dose is designed to conform to the three-dimensional (3-D) shape of the tumor by modulating—or controlling—the intensity of the radiation beam to focus a higher radiation dose to the tumor while minimizing radiation exposure to healthy cells. See the IMRT page for more information.
Surgery, also called surgical resection, is often indicated for primary brain tumors. A surgeon removes some or the entire tumor without causing severe damage to surrounding tissues. Surgery may also be used to reduce pressure within the skull (called intracranial pressure) and to relieve symptoms (called palliative treatment) in cases when the tumor cannot be removed.
Chemotherapy, or anticancer medications, may be recommended. Chemotherapy, along with radiation (concurrent therapy), has become the standard of care for primary malignant brain tumors. The use of these drugs or chemicals to slow down or kill rapidly dividing cells can be used before, during, or after surgery to help destroy tumor cells and to prevent them from returning. Chemotherapy drugs may be taken by pill or by injection and are often used in combination. Drugs called radiosensitizers, which are believed to make radiation therapy more effective, may also be prescribed.
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