Treatment of Brain Tumor
Which therapies are used to treat brain tumors?
Which medications are used for brain tumor patients?
What is radiation therapy?
What is stereotactic radiosurgery?
What is chemotherapy?
What are the newest chemotherapy drugs?
What is gene therapy?
1. Which therapies are used to treat brain tumors?
Surgery is the chief form of treatment for brain tumors that
lie within the membranes covering the brain or in parts of
the brain that can be removed without damaging critical
neurological functions. Because a tumor will recur if any
tumor cells are left behind, the surgeon's goal is to remove
the entire tumor whenever possible. Radiation therapy and
chemotherapy, in general, are used as secondary or adjuvant
treatment for tumors that cannot be cured by surgery alone.
2. Which medications are used for brain tumor patients?
Steroids and anti-convulsants (to stop seizures) are the most
common medications used for brain tumor patients. Steroids
are given to reduce inflammation of tissues and control
swelling of the brain, particularly before and after
surgery. They do not kill tumor cells, but used alone or
combined with other forms of treatment, can cause remarkable
improvement in a patients condition. If used for only a few
days, steroids generally cause no side effects, but used
over a long time or withdrawn without monitoring, steroids
may produce several side effects. You should discuss
monitoring of the steroid and all possible side effects with
Other drugs commonly used with brain tumor patients are anti-convulsants.
Some are used to keep seizures from happening (prophylactic)
while others cut short (abort) seizures that have already
started. Some of the more common drugs now used to prevent
seizures are Dilantin, Tegratol, Depakote, and
Phenobarbital. It is important to remember that side effects
of these drugs vary greatly from person to person. But if
side effects are a serious problem, there are plenty of
newer drugs that can be used, either alone or in combination
with others. Newer drugs include Neurontin (gabapentin),
Topomax (toiramate), Lamictal (lamotrigine) and Gabitril (tiagabine).
3. What is radiation therapy?
Radiation therapy is mainly used after surgery for tumors that
cannot be removed completely, as well as for cases in which
surgery would involve too great a risk to the patient. It
may be given in a single dose each day, usually for 30 days
with weekends off, or it may be "hyper fractionated" into
two or more doses daily for the recommended course of
Standard radiation therapy delivers an external beam of
radiation aimed at an entire region, such as the portion of
the brain containing the tumor and typically delivers a
daily dose of 1.8-2.0 Gy (Gray) to a total dose of 50-60 Gy
over 5-7 weeks.
4. What is stereotactic radiosurgery?
Stereotactic radiosurgery is a non-invasive therapeutic
alternative for treating brain disorders. Instead of a
scalpel, clinicians using stereotactic radiosurgery
technology aim multiple"pencil-thin" beams or arced beams of
high energy particles directly at the tumor site while
sparing healthy tissue as much as possible. With
stereotactic radiosurgery techniques, a higher dose of
radiation is delivered to the specific site (or tumor) of
15-20 Gy and is usually given in one day. Both Gamma Knife
and LINAC X Knife are types of stereotactic radiosurgery.
5. What is chemotherapy?
Chemotherapy works to destroy tumor cells with drugs that may
be given either alone or in combination with other
treatments. A key problem with chemotherapy has been the
difficulty in delivering sufficient amounts of drug directly
to the tumor while sparing normal brain cells. Another
problem is the blood-brain barrier mechanism that normally
serve to keep harmful substances out of the brain -
unfortunately, this same blood-brain barrier can also work
to keep potentially helpful drugs out of the brain. Although
chemotherapy is usually given by mouth or injected in the
vein, some new techniques of intratumoral chemotherapy use
either small pumps or biodegradable wafers to place the drug
inside the tumor.
6. What are the newest chemotherapy drugs?
There is currently a great deal of scientific activity focused
on the area of the discovery of new chemotherapy drugs, many
with novel or alternative mechanisms of action (how drugs
work). Following is a brief list of the various categories
of chemotherapies being used to treat brain tumors:
Cytotoxic Agents, Anti-angiogenic drugs, Differentiating
agents, Anti-invasion agents, Cell signal transduction
modulators and Growth factor inhibitors.
7. What is gene therapy?
Currently for patients with malignant brain tumors who have a
recurrence after surgery, radiation therapy or chemotherapy,
gene therapy may provide an experimental option for
treatment. Using gene therapy, researchers inject a
substance into the brain tumor that changes the genetic
makeup of the tumor cells.