-- Mary Elizabeth Dallas
FRIDAY, Jan. 11 (HealthDay News) -- Treating aggressive brain
tumors called glioblastomas with smaller, more focused areas of
radiation does not increase the likelihood of tumor recurrence, a
new study finds.
Restricting the radiotherapy to a smaller zone also spares the
rest of the brain and preserves patients' brain function, the
One outside expert explained that for many years, radiation
treatment was spread over a larger area of the brain.
"Glioblastoma multiforme is one of the most deadly brain cancers despite aggressive treatment with surgery, radiation therapy and chemotherapy," said Dr. Louis Cornacchia, director of neurosurgery at Brookdale University Hospital and Medical Center, New York City. "For this reason, doctors who give radiation therapy have tended to treat the tumor plus a large margin (10 to 20 millimeters or more) outside the tumor on the theory that more radiation might improve outcomes."
However, "the down side is that the more brain that gets
irradiated, the higher the risk of complications like cognitive
[mental] dysfunction and radiation necrosis [tissue death],"
But the new study suggests that focusing radiation on a narrower
area might have its advantages.
"We are the first to show definitively that people with smaller margins [areas of treatment] don't do any worse than those with larger margins," the study's lead investigator, Dr. Michael Chan, assistant professor of radiation oncology at Wake Forest Baptist Medical Center, said in a university news release.
"For patients with glioblastoma, we now know we can safely and effectively treat them with smaller radiation fields to spare the rest of their normal brain. That's important because it lessens the symptoms from radiation toxicity like tiredness and nausea."
For the study, published recently online in the
American Journal of Clinical Oncology, researchers examined
the medical records of 161 patients treated over the past decade
Although medical advancements have not dramatically improved
patients' long-term survival rates, the researchers noted that
using smaller radiation margins may improve patients' quality of
"Treatments have gotten better over time and people with glioblastoma may live longer than they had in the past. Our study found that the margins did not affect where the [tumor] came back or how long it took it to come back and it did not affect the overall survival," Chan pointed out. "This could potentially be practice-changing."
Another outside expert agreed.
"This study is further proof supporting the trend towards using focal radiation treatments for patients with brain tumors," said Dr. Michael Schulder, vice chairman of the department of neurosurgery at North Shore University Hospital in Manhasset, NY.
"The concerns that many people have that radiation will cause brain injury have been to a large extent alleviated by modern techniques of radiation therapy," he noted.
Schulder believes that with the increased use of radiation that
spares normal tissues around tumors, these therapies "will play an
increasingly important role in managing tumors throughout the body
and in particular the brain."
For his part, Cornacchia said that while the results of the new
study are promising, "more powerful prospective, double-blind
studies will be required to more confidently resolve the
controversy of how large a treatment margin is best for treatment
of glioblastoma multiforme tumors."
The American Cancer Society provides more information on the
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