TREATMENT FOR BRAIN TUMORS
Typical treatment following surgical removal of a brain tumor consists of six to eight weeks of traditional X-ray therapy. The University of Illinois Medical Center at Chicago is the first in the area to offer a new follow-up treatment for malignant brain tumors: delivering radiation directly into the tumor cavity.
Low-level radiation is released continuously through a small device implanted in the cavity and later removed. Treatment lasts about a week.
The new treatment minimizes exposure of healthy tissue to radiation. As a consequence, the potential for side effects such as nausea is limited.
"Preliminary data suggest that this may be an important new option for patients with malignant brain tumors and may possibly offer more effective treatment than the usual therapy," said Dr. Herbert Engelhard, director of the UIC neuro-oncology program.
Although the first patients to receive radiation with the new device will remain hospitalized, future patients could potentially receive treatment on an outpatient basis, Engelhard said.
According to the American Cancer Society, each year more than 16,000 Americans are diagnosed with primary malignant brain tumors, which arise within the brain tissue itself. A far larger number of patients have metastatic brain tumors that have spread from other areas of the body, such as the lung or breast.
Treatment for both types of tumors typically involves surgery, followed by a course of radiation. In traditional radiation therapy, X-rays pass through healthy brain tissue to reach the tumor cavity.
The new treatment uses an implanted device, made by Proxima Therapeutics, Inc., to deliver an even, easily controlled dose of radiation to the targeted area. At the time of surgery, an expandable balloon is inserted into the tumor cavity. The balloon is connected by a thin catheter to a small reservoir placed just beneath the patient's scalp. After one to two weeks, the balloon is filled with a liquid source of radiation. Over a course of three to seven days, the radiation is delivered through the balloon directly to the tissue surrounding the cavity, where tumors are most likely to recur. After treatment, the system is removed.
"Preliminary studies have suggested that the risk of harmful side effects such as radiation necrosis -irreversible damage to surrounding tissue - is markedly lower with this technique than with alternatives," Engelhard said. "Moreover, the recovery time is short and side effects are limited."
In the past, patients with recurring brain tumors have had few treatment options. A second course of traditional radiation typically isn't advised for a recurring tumor because of the high risk of damage to surrounding brain tissue that remains healthy.
The reliability of the new device, which was recently approved by the federal Food and Drug Administration, was demonstrated in a recent National Cancer Institute-sponsored study of patients with recurring primary brain tumors, all of whom had undergone previous surgery and radiation therapy and half of whom had received chemotherapy. The study found a high rate of patient survival and, after a year, no evidence of radiation necrosis that required surgery.
For more information on the Brain Tumor Center at the University of Illinois Medical Center at Chicago, visit www.braintumordoc.org.
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