CNS tumor treatment options
Patients with central nervous system (CNS) tumors have several treatment options at WVCI, including, radiation therapy, incision-free Gamma Knife radiosurgery, chemotherapy and Optune treatment for specific tumor conditions. Many patients choose a combination of treatments, based on the recommendations of their physician. Clinical trials may also be an option.
The choice of treatment depends mainly on the following:
- The type and grade of the tumor
- Its location in the body
- The patient’s age and general health
Your doctor can describe your treatment choices, the expected results and the possible side effects. You and your oncology care team will work to develop a treatment plan that’s customized for you.
Advances in radiation technology have given us the ability to pinpoint cancer and avoid or minimize damage to surrounding healthy tissue during treatment. One of the techniques we use to accomplish this is intensity-modulated radiotherapy (IMRT). This radiation technique allows us to safely deliver precise radiation doses to a tumor while minimizing the dose to surrounding normal tissue.
This incision-free stereotactic radiosurgery (SRS) is used for select brain conditions when the target is small. With Gamma Knife, multiple tumors can be treated at once, using 3-D imaging and precisely focused, high-dose gamma rays, directed at the tumor(s) or lesions in the head or neck from multiple angles. This type of treatment minimizes the risk of damaging healthy tissue and is performed on an outpatient basis.
Gamma Knife radiation is used to treat both malignant and benign tumors, including brain metastases, meningiomas, acoustic neuromas, trigeminal neuralgia, pituitary adenomas, pituitary glial tumors and other conditions.
Our radiation oncologists work closely with Oregon Neurosurgery surgeons to perform this treatment at PeaceHealth RiverBend Gamma Knife Center. Gamma Knife is a registered trademark of Elekta Instruments, Inc.
Chemotherapy uses powerful drugs to kill cancer cells or stop them from growing or dividing. These drugs are usually given by pill or injection and travel through the body to the brain, or can be inserted surgically using dissolvable wafers that have been soaked in a chemotherapeutic drug. These wafers slowly release a high concentrate of the drug to kill any remaining malignant cells. Chemotherapy may also be given to kill cancer cells in the spinal column.
Chemotherapy is given in cycles to more effectively harm cancer cells and give normal cells time to recover from any damage. Your oncologist will base the treatment on the type of cancer, drug(s) to be used, the frequency of administration, and the number of cycles needed.
Patients might receive chemotherapy to shrink the tumor before surgery (called neo-adjuvant therapy), in combination with radiation therapy, or after radiation treatment (called adjuvant therapy) to destroy any remaining cancer cells. Metronomic therapy involves giving continuous low-dose chemotherapy to block mechanisms that stimulate the growth of new blood vessels needed to feed the tumor. Chemotherapy is also used to treat central nervous system (CNS) lymphoma and inaccessible tumors or tumors that do not respond to radiation therapy.
This is an FDA-approved novel therapeutic option which, studies have shown, slows and reverses tumor growth by inhibiting mitosis – the process by which cells divide and replicate. It is intended as a treatment for adult patients (22 years of age or older) with histologically confirmed glioblastoma multiforme (GBM).
Glioblastoma can be difficult to treat, because the tumors contain many different types of cells. A patient’s treatment plan for glioblastoma may combine several approaches, because some cells may respond well to certain therapies, while others may not be affected at all.
Optune is used in combination with temozolomide (TMZ) chemotherapy, after surgery, radiation and chemotherapy has been completed.
For the treatment of recurrent GBM, Optune is indicated following histologically-or radiologically-confirmed tumor recurrence after receiving chemotherapy. The device is intended to be used as monotherapy as an alternative to standard medical therapy after surgical and radiation options have been exhausted.
How it works: Optune delivers Tumor Treating Fields (TTFields) to selectively disrupt mitosis in dividing cancer cells. TTFields are frequency-specific, low-intensity alternating electric fields that interrupt cancer cell structures during division and may cause cancer cells to die. Optune is a portable, noninvasive medical device designed for continuous use (at least 18 hours per day) by patients, allowing patients to go about their normal, daily routine without the typical side effects of other types of cancer treatments.
WVCI is a certified Optune treatment center. Learn more here.