Radiation therapy can be used to control the growth of brain and spine cancers and also to treat pain and other tumor side effects. In the Brain and Spine Tumor Program, radiation oncologists work closely with the entire physician team to integrate radiation treatment into care planning.
Therapeutic Radiation for Brain TumorsNormal cells within the human body have the ability to repair damage to their DNA. One of the characteristics of cancer cells (including brain and spine tumor cells) is that they have largely lost this repair ability. Therapeutic radiation damages the DNA of cancer cells. Since the cell cannot repair this damage, it dies.
Some brain tumors are more sensitive to radiation than others. For certain tumors such as malignant glioma, radiation therapy is more effective when used in combination with chemotherapy.
Treatment planning for radiation therapy is a detailed process. First, CT and MRI scans are performed to identify both the tumor target and areas of the brain at risk during treatment. A radiation oncologist works with a licensed medical dosimetrist to model a radiation treatment plan that achieves the goals of (1) delivering a maximal dose of radiation to the tumor and (2) minimizing radiation delivered to healthy tissues.
Standard radiation therapy for brain tumorsIn the standard radiation course for brain tumors, patients receive treatment every weekday for 6 weeks, for a total of 30 treatment sessions. Patients typically spend about 15 minutes in the treatment room, with the actual radiation treatment taking 5 to 10 minutes.
Pulsed low-dose-rate radiation therapy for recurrent tumorA radiation technique developed by Christopher Schultz, MD, Medical College of Wisconsin radiation oncologist, is now being used to treat patients with recurrent glioma. Because of potential damage to normal brain structures, brain tumors that recur after a prior course of radiation are usually not re-radiated. Pulsed low-dose-rate radiation therapy delivers short bursts of radiation in lower doses, which appears to be much more harmful to tumor cells than normal cells. This enables patients who have had previous radiotherapy to undergo another course of radiation for recurrent tumor.
Controlling Side Effects of Brain CancerCancers that have spread to the brain from other parts of the body can cause a variety of neurological side effects, including headaches, nausea, poor arm and leg function, numbness and tingling, and changes in cognitive ability. For patients who experience these problems, radiation therapy can help improve their quality of life.
Radiation treatment reduces the “tumor burden” of the brain, which can significantly diminish neurological side effects or completely resolve them. Brain metastases can be treated with either standard external beam radiation or Gamma Knife radiosurgery.
Treating Spine MetastasesRadiation therapy can also be used to treat painful metastatic tumors in the spine. Standard therapy involves 10 to 15 treatment sessions.
Physicians at Froedtert & The Medical College of Wisconsin are currently investigating a new technique called stereotactic spine radiation therapy. Using the TomoTherapy radiation system, a very high dose of radiation is delivered to the tumor site. Because of the accuracy and strength of the dose, treatment takes place in a single session. Preliminary results are promising, with some patients experiencing significantly reduced pain within 24 hours.
Prophylactic Brain IrradiationFor certain patients with small cell lung cancer, radiation delivered to the brain can help prevent the development of brain metastases. Prophylactic brain irradiation (PBI) is usually delivered in 10 sessions over 2 weeks. PBI is an option for patients whose lung cancer has responded well to chemotherapy and radiation. It has been shown to reduce the incidence of brain metastases from small cell lung cancer by approximately 50 percent.
Full Range of Precise Radiation TechnologiesPatients in the Brain and Spine Tumor Program have access to a full range of technologies for delivering therapeutic radiation to precise tumor targets.
Many of the systems incorporate onboard imaging systems, which enables highly accurate Image-Guided Radiation Therapy (IGRT). A number of the units allow the radiation oncology team to create dose patterns that conform very tightly to the size and shape of the tumor. Together, IGRT and conformal therapy enable physicians to deliver higher doses of radiation to tumors while sparing healthy brain and spine tissues.
Radiation systems available at Froedtert & The Medical College of Wisconsin include TomoTherapy, Cone-Beam CT, CT on Rails, and Gamma Knife.
TomoTherapyAn advanced linear accelerator system with a built-in low-dose CT scanner, this unit allows the care team to confirm the tumor target and make necessary adjustments before every treatment session. Radiation is delivered from a full 360-degree circle, enabling a greater ability to shape therapy to the tumor and avoid critical brain structures. Learn more about TomoTherapy.
Cone-Beam CTTwo linear accelerator systems at the Clinical Cancer Center incorporate a cone-beam CT imaging device. This advanced imaging system provides another method for ensuring the highest level of radiation accuracy and treatment effectiveness.
CT on RailsThis independent CT unit provides IGRT capabilities to radiation systems that do not have onboard imaging. Learn more about CT on Rails.
Gamma KnifeThis system delivers a highly focused dose of radiation to precise targets within the brain. Often used for patients with brain metastases, Gamma Knife can treat cancerous lesions in a single session.
Last Review Date: Sept. 30, 2010
Online Editor(s): Richard Petre