Different types of treatment are available for patients with adult brain tumor. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. Before starting treatment, patients may want to think about taking part in a clinical trial. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment.
Clinical trials are taking place in many parts of the country. To learn more about clinical trials, call the Cancer Information Service at 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615. Information about ongoing clinical trials is available from the NCI Web site. Choosing the most appropriate cancer treatment is a decision that ideally involves the patient, family, and health care team.
Three types of standard treatment are used.
Surgery: Surgery is used, when possible, to treat adult brain tumor, as described in the Description section of this summary.
- Radiation therapy: Radiation therapy is a cancer treatment that uses high-energy X-rays or other types of radiation to kill cancer cells. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated.
- Chemotherapy: Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the spinal column, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). A dissolving wafer may be used to deliver an anticancer drug directly into the brain tumor site after the tumor has been removed by surgery. The way the chemotherapy is given depends on the type and stage of the cancer being treated.
Other types of treatment are being tested in clinical trials.
New methods of delivering radiation therapy
- Radiosensitizers: Drugs that make tumor cells more sensitive to radiation. Combining radiation with radiosensitizers may kill more tumor cells.
- Hyperfractionation: Radiation therapy given in smaller-than-usual doses two or three times a day instead of once a day.
- Stereotactic radiosurgery: A radiation therapy technique that delivers radiation directly to the tumor with less damage to healthy tissue. The doctor uses a CT scan or MRI to find the exact location of the tumor. A rigid head frame is attached to the skull and high-dose radiation is directed to the tumor through openings in the head frame, reducing the amount of radiation given to normal brain tissue. This procedure does not involve surgery. This is also called stereotactic radiosurgery and gamma knife therapy.
Hyperthermia therapy
Hyperthermia therapy is a treatment in which body tissue is exposed to high temperatures to damage and kill cancer cells or to make cancer cells more sensitive to the effects of radiation and certain anticancer drugs.
Biologic therapy
Biologic therapy is a treatment that uses the patient's immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body's natural defenses against cancer. This type of cancer treatment is also called biotherapy or immunotherapy.
How are metastatic brain tumors treated?
Tumors that have spread to the brain from somewhere else in the body are usually treated with radiation therapy and/or surgery. Chemotherapy may be used if the primary tumor is the kind that responds well to chemotherapy. Clinical trials are under way to study new treatments.
Treatment Options by Type of Adult Brain Tumor
Brain Stem Gliomas
Treatment of brain stem gliomas may include the following:
- Hyperfractionated radiation therapy.
- A clinical trial of new anticancer drugs and/or biologic therapy.
- Pineal Astrocytic Tumors
Treatment of pineal astrocytic tumors may include the following:
- Surgery and radiation therapy, with or without chemotherapy.
- A clinical trial of external radiation therapy plus hyperthermia therapy or new methods of delivering radiation therapy.
- A clinical trial of new anticancer drugs and biologic therapy following radiation therapy.
Pilocytic Astrocytomas
Treatment of pilocytic astrocytoma is usually surgery with or without radiation therapy.
Diffuse Astrocytomas
Treatment of diffuse astrocytoma may include the following:
- Surgery, usually with radiation therapy.
- A clinical trial of surgery and radiation therapy with or without chemotherapy for tumors that cannot be completely removed by surgery.
- A clinical trial of radiation therapy delayed until the tumor progresses.
- A clinical trial comparing high-dose and low-dose radiation therapy.
Anaplastic Astrocytomas
Treatment of anaplastic astrocytoma may include the following:
- Surgery plus radiation therapy, with or without chemotherapy.
- A clinical trial of external radiation therapy plus hyperthermia therapy or new methods of delivering radiation therapy.
- A clinical trial of new anticancer drugs and biologic therapy following radiation therapy.
- A clinical trial of chemotherapy combined with different methods of delivering radiation therapy.
Glioblastoma
Treatment of glioblastoma may include the following:
- Surgery plus radiation therapy, with or without chemotherapy.
- A clinical trial of chemotherapy placed into the brain during surgery.
- A clinical trial of radiation and concurrent chemotherapy.
- A clinical trial of external radiation therapy plus hyperthermia therapy or new methods of delivering radiation therapy.
- A clinical trial of new anticancer drugs and biologic therapy following radiation therapy.
- A clinical trial of chemotherapy and new methods of delivering radiation therapy.
- Clinical trials of new treatments.
Oligodendroglial Tumors
Treatment of oligodendrogliomas may include the following:
- Surgery, usually with radiation therapy.
- A clinical trial of surgery and radiation therapy with or without chemotherapy for tumors that cannot be completely removed by surgery.
- A clinical trial of chemotherapy using one or more drugs.
Treatment of anaplastic oligodendroglioma may include the following:
- Surgery plus radiation therapy with or without chemotherapy.
- Chemotherapy using more than one drug.
- Radiation therapy with or without chemotherapy using more than one drug.
- Clinical trials of new treatments.
Mixed Gliomas
Treatment of mixed gliomas may include the following:
- Surgery plus radiation therapy with or without chemotherapy.
- A clinical trial of external radiation therapy plus hyperthermia therapy or new methods of delivering radiation therapy.
- A clinical trial of new anticancer drugs or biologic therapy following radiation therapy.
Ependymal Tumors
Treatment of grade I and grade II ependymomas is usually surgery with or without radiation therapy.
Treatment of anaplastic ependymoma may include the following:
- Surgery plus radiation therapy.
- A clinical trial of surgery followed by chemotherapy before, during, and after radiation therapy.
- A clinical trial of chemotherapy and/or biologic therapy.
Medulloblastoma
Treatment of medulloblastomas may include the following:
- Surgery plus radiation therapy to the brain and spine.
- A clinical trial of surgery and radiation therapy to the brain and spine for tumors that are more difficult to treat successfully.
- A clinical trial of chemotherapy.
Pineal Parenchymal Tumors
Treatment of pineal parenchymal tumors may include the following:
- Surgery plus radiation therapy with or without chemotherapy.
- A clinical trial of external radiation therapy plus hyperthermia therapy or new methods of delivering radiation therapy.
- A clinical trial of new anticancer drugs and biologic therapy following radiation therapy.
Meningeal Tumors
Treatment of meningiomas may include the following:
- Surgery with or without radiation therapy.
- Radiation therapy for tumors that cannot be removed by surgery.
Treatment of malignant meningioma may include the following:
- Surgery plus radiation therapy.
- A clinical trial of external radiation therapy plus hyperthermia therapy or new methods of delivering radiation therapy.
- A clinical trial of new anticancer drugs and/or biologic therapy following radiation therapy.
Germ Cell Tumors
Treatment of central nervous system germ cell tumors depends on the type of cancer cells, the location of the tumor, whether the cancer can be removed in an operation, and other factors.
Craniopharyngioma
Treatment of craniopharyngiomas may include the following:
- Surgery to remove the entire tumor.
- Surgery to remove as much of the tumor as possible, followed by radiation therapy.
Pituitary Tumors
Surgery with or without radiation therapy. Sometimes special drugs other than chemotherapy may be used to control symptoms from these tumors.
Recurrent Adult Brain Tumor
Treatment of recurrent adult brain tumors may include the following:
- Surgery with or without chemotherapy.
- Radiation therapy, if not used during previous treatment, with or without chemotherapy.
- Internal radiation therapy.
- Chemotherapy.
- A clinical trial of new anticancer drugs.
- A clinical trial of chemotherapy placed into the brain during surgery.
- A clinical trial of biologic therapy.
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