Treatment for brain cancer depends on a number of factors, including the type, location and size of the tumor as well as the patient’s age and general health. Brain tumors can be benign or malignant, primary or metastatic. Even if the tumor is benign, many patients suffer from symptoms if a brain tumor goes untreated.
Historically, brain tumors have been treated first with surgery. However, in many cases, surgery isn’t possible because of the location of the tumor. And with the advances in radiation therapy and radiosurgery, patients have another option to have their tumors treated without undergoing an invasive surgery.
With radiation therapy, or radiotherapy, sometimes the whole brain is given radiation, sometimes only a limited area. When the whole brain needs treatment for brain metastases, radiotherapy is delivered daily, Monday through Friday, for several weeks. Some patients may be eligible for radiosurgery, which is delivered with higher doses in one to five treatment sessions. Some patients can be treated with radiotherapy first, and then radiosurgery, or either one alone. Your radiation oncologist will collaborate with will collaborate with your treatment team to decide on the best technique for your treatment.
Treatment Techniques for Brain Cancer
The following treatment techniques are utilized to deliver radiotherapy and radiosurgery. Your clinical team will decide which method is most appropriate for treating your particular case.
SRS, or stereotactic radiosurgery, is a technique that is most commonly used for tumors in the brain or spinal column. Unlike radiotherapy, SRS is typically delivered in a maximum of five sessions using higher doses of radiation with each session. Despite the use of the word “surgery” in its name, SRS does not involve removing the tumor with a surgical blade. Instead, a focused high-intensity beam of radiation is used to target the tumor.
Until recently, radiosurgery was most often used when the patient could not undergo conventional surgery to remove the tumor(s) because of its size or location, or because the person’s health was too poor for surgery. However, some physicians consider radiosurgery as the first line of treatment for some brain tumors.
IG-VMAT, or image-guided volumetric modulated arc therapy, uses special software and an advanced linear accelerator to deliver treatments up to eight times faster than what was previously possible with standard radiation therapy. Unlike conventional treatments, during which the machine must rotate several times around the patient or make repeated stops to treat the tumor from a number of different angles, VMAT can deliver the dose to the entire tumor in a single rotation — in as little as two minutes.
Image-guided radiation therapy (IGRT) uses sophisticated computer software to analyze a series of image scans to create a detailed, three-dimensional picture of the target area and surrounding tissue, which enables your team to view the tumor and its position in your body before and during each treatment. The scans typically are produced by computed tomography (CT scan), magnetic resonance imaging (MRI), or positron emission tomography (PET scan).
IG-IMRT, or image-guided intensity-modulated radiation therapy utilizes images taken by several scans to create a detailed, three-dimensional picture of the tumor. The scans typically are produced by computed tomography (CT scan), magnetic resonance imaging (MRI), or positron emission tomography (PET scan).
Intensity-modulation involves changing the intensity of the radiation beam at various angles. At each angle, the radiation beam is shaped to closely match the size and shape of the tumor, minimizing exposure to the healthy tissue that surrounds it and reducing the risks of some side effects.