Brain Cancer

General Information | Treatment Options | Additional Resources

Treatment
  • Overview
  • Standard Treatment
  • Clinical Trials
  • Treatment By Type

How are adult brain tumors treated?

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. 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. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.

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 stereotaxic 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 in a clinical trial

For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment.

Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.

Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.

Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment.

Clinical trials are taking place in many parts of the country. In the following lists of treatments for the different types of brain tumors, a link to search results for current clinical trials is included for each section. These have been retrieved from NCI's clinical trials database. For some types of tumors, there may not be any trials listed. Check with your doctor for clinical trials that are not listed here but may be right for you.

Brain Stem Gliomas

Treatment of brain stem gliomas may include the following:

  1. Hyperfractionated radiation therapy.
  2. A clinical trial of new anticancer drugs and/or biologic therapy.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with adult brain stem glioma.

Pineal Astrocytic Tumors

Treatment of pineal astrocytic tumors may include the following:

  1. Surgery and radiation therapy, with or without chemotherapy.
  2. A clinical trial of external radiation therapy plus hyperthermia therapy or new methods of delivering radiation therapy.
  3. A clinical trial of new anticancer drugs and biologic therapy following radiation therapy.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with adult pineal gland astrocytoma.

Pilocytic Astrocytomas

Treatment of pilocytic astrocytoma is usually surgery with or without radiation therapy.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with adult pilocytic astrocytoma.

Diffuse Astrocytomas

Treatment of diffuse astrocytoma may include the following:

  1. Surgery, usually with radiation therapy.
  2. A clinical trial of surgery and radiation therapy with or without chemotherapy for tumors that cannot be completely removed by surgery.
  3. A clinical trial of radiation therapy delayed until the tumor progresses.
  4. A clinical trial comparing high-dose and low-dose radiation therapy.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with adult diffuse astrocytoma.

Anaplastic Astrocytomas

Treatment of anaplastic astrocytoma may include the following:

  1. Surgery plus radiation therapy, with or without chemotherapy.
  2. A clinical trial of external radiation therapy plus hyperthermia therapy or new methods of delivering radiation therapy.
  3. A clinical trial of new anticancer drugs and biologic therapy following radiation therapy.
  4. A clinical trial of chemotherapy combined with different methods of delivering radiation therapy.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with adult anaplastic astrocytoma.

Glioblastoma

Treatment of glioblastoma may include the following:

  1. Surgery plus radiation therapy.
  2. Surgery plus radiation therapy and chemotherapy.
  3. Chemotherapy placed into the brain (Gliadel Wafer) during surgery.
  4. Radiation therapy given together with chemotherapy.
  5. A clinical trial of external radiation therapy plus hyperthermia therapy or new methods of delivering radiation therapy.
  6. A clinical trial of new anticancer drugs or biologic therapy following radiation therapy.
  7. A clinical trial of chemotherapy and new methods of delivering radiation therapy.
  8. Clinical trials of new treatments.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with adult glioblastoma.

Oligodendroglial Tumors

Treatment of oligodendrogliomas may include the following:

  1. Surgery, usually with radiation therapy.
  2. A clinical trial of surgery and radiation therapy with or without chemotherapy for tumors that cannot be completely removed by surgery.
  3. A clinical trial of chemotherapy using one or more drugs.

Treatment of anaplastic oligodendroglioma may include the following:

  1. Surgery plus radiation therapy with or without chemotherapy.
  2. Chemotherapy using more than one drug.
  3. Radiation therapy with or without chemotherapy using more than one drug.
  4. Clinical trials of new treatments.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with adult oligodendroglial tumors.

Mixed Gliomas

Treatment of mixed gliomas may include the following:

  1. Surgery plus radiation therapy with or without chemotherapy.
  2. A clinical trial of external radiation therapy plus hyperthermia therapy or new methods of delivering radiation therapy.
  3. A clinical trial of new anticancer drugs or biologic therapy following radiation therapy.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with mixed gliomas.

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:

  1. Surgery plus radiation therapy.
  2. A clinical trial of surgery followed by chemotherapy before, during, and after radiation therapy.
  3. A clinical trial of chemotherapy and/or biologic therapy.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with adult ependymal tumors.

Medulloblastoma

Treatment of medulloblastomas may include the following:

  1. Surgery plus radiation therapy to the brain and spine.
  2. A clinical trial of surgery and radiation therapy to the brain and spine for tumors that are more difficult to treat successfully.
  3. A clinical trial of chemotherapy.

(Refer to the PDQ summary on Childhood Medulloblastoma Treatment for more information.)

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with adult medulloblastoma.

Pineal Parenchymal Tumors

Treatment of pineal parenchymal tumors may include the following:

  1. Surgery plus radiation therapy with or without chemotherapy.
  2. A clinical trial of external radiation therapy plus hyperthermia therapy or new methods of delivering radiation therapy.
  3. A clinical trial of new anticancer drugs and biologic therapy following radiation therapy.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with adult pineal parenchymal tumor.

Meningeal Tumors

Treatment of meningiomas may include the following:

  1. Surgery with or without radiation therapy.
  2. Radiation therapy for tumors that cannot be removed by surgery.

Treatment of malignant meningioma may include the following:

  1. Surgery plus radiation therapy.
  2. A clinical trial of external radiation therapy plus hyperthermia therapy or new methods of delivering radiation therapy.
  3. A clinical trial of new anticancer drugs and/or biologic therapy following radiation therapy.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with adult meningeal tumor.

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.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with adult central nervous system germ cell tumor.

Craniopharyngioma

Treatment of craniopharyngiomas may include the following:

  1. Surgery to remove the entire tumor.
  2. Surgery to remove as much of the tumor as possible, followed by radiation therapy.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with adult craniopharyngioma.

Recurrent Adult Brain Tumor

Treatment of recurrent adult brain tumors may include the following:

  1. Surgery with or without chemotherapy.
  2. Radiation therapy, if not used during previous treatment, with or without chemotherapy.
  3. Internal radiation therapy.
  4. Chemotherapy.
  5. A clinical trial of new anticancer drugs.
  6. A clinical trial of chemotherapy placed into the brain during surgery.
  7. A clinical trial of biologic therapy.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with recurrent adult brain tumor.

Metastatic Brain Tumors

Treatment of a single metastatic brain tumor is usually surgery followed by radiation therapy to the brain.

Treatment of more than one metastatic brain tumor may include the following:

  1. Radiation therapy to the brain.
  2. Surgery, for large tumors that are pressing on areas of the brain and causing symptoms.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with adult tumors metastatic to brain.

Cancer information from the NCI PDQ service