• Conditions Treated

  • Arteriovenous Malformation
  • Bone Metastases
  • Brain Tumors
    • Gliomas
    • Brain Metastases
    • Pituitary Adenoma
    • Meningioma
    • Acoustic Neuroma
  • Kidney Tumors
  • Liver Tumors
  • Lung Tumors
  • Ocular / Orbital Tumors
  • Pancreatic Cancer
  • Prostate Cancer
  • Spinal Tumors
  • Trigeminal Neuralgia

Gliomas

Including:

• Astrocytoma
• Glioblastoma Multiforme
• Glioma
• Oligodendroglioma

A glioma is a class of tumor that develops from glial cells in the brain that support and protect neurons. Astrocytes, ependymal, and oligodendroglial cells are all examples of glial cells.

Low-grade gliomas are slow growing and assigned a grade of I or II. For practical reasons, grade-I tumors are usually excluded when discussing gliomas. High-grade gliomas are malignant and grow quickly. They’re assigned a grade of III or IV. Malignant gliomas are among the most devastating tumors. However, major advances have improved doctors’ understanding of them.

What are the symptoms of a glioma?

Glioma symptoms depend on the tumor location and growth rate. Common symptoms include:

• Nausea, vomiting headaches and seizures
• Difficulty speaking
• Weakness or paralysis in one part of the body or face
• Impaired vision or sense of touch
• Impaired sense of balance
• Behavioral changes
• Impaired memory or thinking

In evaluating brain tumors, an MRI is usually performed. Other scanning systems can help identify characteristics such as a tumor’s chemical make-up and growth rate. These noninvasive tests are helpful, but biopsy is the gold standard method for determining a glioma diagnosis.

What are the treatment options?

Malignant gliomas are treated with surgery, radiation therapy and chemotherapy.

Surgery

Primary treatment for malignant gliomas is open surgery known as a craniotomy, in which a small window is cut into the skull to access the tumor. Doctors remove as much of the tumor as possible without damaging neurological functions. Despite advances in neurosurgery, craniotomy procedures are very challenging. New technologies such as operating microscopes, micro-dissection, computerized image guidance, ultrasound, brain mapping and real-time MRI imaging make surgical removal of gliomas safer than ever. Among anaplastic astrocytoma and glioblastoma patients, surgery can offer a survival rate of 97 percent or better.

Though it may not completely cure gliomal tumors, surgical removal can provide immediate relief from glioblastoma symptoms and improve the effectiveness of other forms of treatment. If not removed, internal portions of these tumors can be particularly resistant to radiation and chemotherapy. Surgical removal also provides the best tissue sampling for tumor analysis and diagnosis.

Radiation therapy and chemotherapy

Radiation therapy and chemotherapy are used widely as secondary treatment following surgery. Both therapies slow the growth of tumors. For patients who are not surgical candidates, radiation or chemotherapy can be used as initial treatment but typically only after a biopsy for diagnosis.

Typical radiation therapy systems use a linear accelerator to fire radiation beams at a tumor from multiple directions. Most also use computer-controlled beam shaping that allows the beams to match the shape of the tumor. One of these techniques known as intensity-modulated radiation therapy (IMRT) is designed to vary the shape as well as intensity of each radiation beam.

Radiation therapy can produce side effects that occur in a matter of days or weeks after treatment, though they’re usually short-term. Patients can experience fatigue, loss of appetite and nausea. In addition, skin rashes and hair loss can occur when a tumor or lesion in the head is treated.

Delayed side effects that occur months or years after treatment include varying degrees of memory loss and impaired thinking. Rarely, patients experience impaired pituitary function or radiation necrosis, an area of dead tumor cells and scar tissue. Radiation necrosis can produce symptoms that are often similar to those caused by the tumor, such as severe headache, weakened motor skills, vision problems or seizures.

Stereotactic radiosurgery

High-grade gliomas often regrow despite aggressive surgical removal, conventional radiation therapy, and chemotherapy. Many patients experience tumor regrowth, known as a recurrence, often at the margins of the previously treated tumor. Treatment for high-grade gliomas is highly individualized, but radiosurgery can often play a role after initial therapy or at the time of recurrence. Radiosurgery in these situations can improve quality of life and prolong survival.

Several radiosurgery systems are capable of high-dose radiation treatment with a variety of radiation sources. Nearly all methods use a metal frame attached to the patient’s skull with screws that immobilizes the head to accurately target the tumor. Local anesthetic is used for mounting the frames, though frames can be uncomfortable and painful to some extent.

Unlike most radiosurgery systems, CyberKnife does not use an invasive head frame. It also enables glioma patients to receive a large radiation dose in segments. Known as fractionated radiosurgery, this method is particularly beneficial for patients who have previously received large-dose radiation therapy, as well as those with gliomas near critical structures in the brain.