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22

NCCN Guidelines for Patients

®

:

Brain Cancer – Gliomas, Version 1.2016

2

Test and treatment overview

Radiation therapy

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

days.

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.

Conformal techniques

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:

†

†

3D-CRT (

three

-

d

imensional

c

onformal

r

adiation

t

herapy) uses photon beams from

different angles that match the shape of the

tumor.

†

†

IMRT (

i

ntensity-

m

odulated

r

adiation

t

herapy) is

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.

†

†

VMAT (

v

olu

m

etric

a

rc-based

t

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.

Receiving radiation

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.