Chemotherapy and Radiation for Brain Tumors

Chemotherapy and radiation are two protocols used in brain tumor treatment plans. In chemotherapy, drugs are taken orally or injected, with the aim of destroying tumor cells in the body. While it can be very effective for other cancers, chemotherapy is not the primary treatment of choice for patients with brain tumors. Radiation treatment is widely used as a brain tumor treatment, and works by focusing external radiation beams at the tumor cells.
Chemotherapy and radiation treatments are usually used in combination with other types of brain tumor treatments to ensure success in eliminating tumor cells.

Chemotherapy

Chemotherapy works to destroy tumor cells by interrupting the cell division process. The drug is either ingested or injected in cycles, giving the patient time off between each dose and allowing the chemotherapy drug time to perform its job. Usually, the patient receives the drug, and then waits four to six weeks before the next treatment.
However, because brain tumors tend to grow very slowly, interrupting cell reproduction with chemotherapy is not generally an effective brain tumor treatment. Also, chemotherapy drugs have a hard time crossing the blood-brain barrier to reach the tumor. Arteries and capillaries in the central nervous system work to protect the brain from chemical exposure by limiting what passes through from the bloodstream into the brain.
One chemotherapy method that has proven successful is a localized treatment used during surgery. After removing the brain tumor, the surgeon places several drug-soaked wafers into the tumor cavity. These wafers dissolve over several days, and release the chemotherapy drugs into the surrounding tissue. Because the drug is used locally and isn't destroying all rapidly-dividing cells in the body (such as hair follicle cells), side effects are greatly reduced.
Children are more likely to receive chemotherapy as a brain cancer treatment than adults, usually to delay radiation treatment as long as possible.

Radiation Treatment

Radiation therapy is a brain tumor treatment often used after surgery to kill hidden cancer cells left behind or to target brain tumors that can't be excised surgically. During radiation treatment a large machine focuses high-energy rays at the brain tumor and surrounding tissue. This external beam radiation can be used on the entire brain or just focused on one area. If a patient has several brain tumors that couldn't be removed surgically, whole brain radiation can reach all the tumors. Tumors that have metastasized to the brain can also be targeted with whole brain radiation.
Doctors can administer radiation treatment in several different ways to ensure that healthy brain tissue doesn't get damaged. These include:

  • Fractionation: Administering radiation five days a week over several weeks
  • Hyperfractionation: Giving small radiation doses two or three times a day instead of one larger dose a day
  • Proton beam: Using proton beams instead of x-rays; protons don't destroy healthy tissue when they pass through
  • Stereotactic radiotherapy: Aiming several beams at the tumor from different angles; administered over several visits
  • 3-dimensional conformal: Using a computer-generated 3-dimensional tumor image to aim beams at the tumor's exact shape.

When chemotherapy and radiation aren't effective treatment options, doctors may prescribe brain tumor drugs. These drugs affect cell growth, blood flow to the cells and the ability of the tumor to grow.

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