NCCN Guidelines for Patients
Brain Cancer – Gliomas, Version 1.2016
Test and treatment overview
For a brain tumor, you will need to wear a head
mask. The mask will keep your head still during
treatment. It also helps keep you in the same
treatment position at every visit.
The mask is made with a mesh material and will
be shaped to your face before simulation. First, the
mask will be warmed in water and then pressed
down into the contours of your face. Afterward, the
mask will be removed and will harden in several
For a spinal tumor, a special mold of your body may
be made. The mold helps to place you in the right
position for treatment. You may also have small ink
marks tattooed on your skin to help direct treatment.
Using the pictures, your radiation team will plan the
best radiation dose, number and shape of radiation
beams, and number of treatment sessions. A team
consists of doctors, medical physicists, and technical
experts in radiation planning. The radiation dose is
shaped with computer software and hardware added
to the radiation machine.
EBRT is given to shape the radiation dose to the
tumor so healthy tissue around the tumor is spared.
However, some healthy tissue still gets radiated. The
types of conformal radiation include:
herapy) uses photon beams from
different angles that match the shape of the
a more precise form of 3D-CRT. The radiation
beam is divided into smaller beams at many
different angles and the strength of each beam
can vary. The beams intersect at the tumor.
During treatment, the radiation machine will
move around you.
herapy) is like
IMRT but delivers treatments in an arc shape
around the tumor.
Craniospinal radiation treats the entire brain
and spinal cord with conformal radiation. It is
sometimes used to treat brain tumors that have
spread into the spine.
Proton therapy is very much like 3D-CRT but
uses proton beams instead of photon beams.
Proton beams deliver radiation mostly within
the tumor. You can only receive proton therapy
at some treatment centers because it requires
special machines. Your doctor may use proton
beams for craniospinal radiation if he or she
thinks it may cause fewer side effects.
Stereotactic radiosurgery (SRS, for short) uses
photon or proton beams that deliver a large
radiation dose within a small area. It may be
used for gliomas that have returned after the
first round of therapy. It may also sometimes be
used for spinal tumors.
During treatment, you will lie on a table in the same
position as done for simulation. To treat brain tumors,
you must wear your mask. Other devices may be
used to keep you from moving. For spinal treatment,
a body mold may be used to keep you from moving.