which focuses primarily on the tumor.
Radiation therapy for tumors of the brain or central nervous system
involves the delivery of high-energy radiation through several
Image Guided Radiation Therapy (IGRT). Through real time image-guided radiation therapy, this advanced system allows radiation oncologists to "see before they treat," offering unparalleled tumor targeting and normal tissue sparing.
Intensity Modulated Radiation Therapy
(IMRT). This is a highly
advanced form of radiation, which shapes radiation beams to closely
approximate the shape of the tumor, allowing us to treat the cancer while
minimizing dose to surrounding normal tissues.
whose advanced capabilities allows precise targeting of high doses
of radiation at the tumor during one treatment session.
At Monmouth Medical Center’s Institute for Advanced Radiation
Oncology, the Neuroscience Institute is led by a team of highly
experienced and skilled neurosurgeons and radiation oncologists
that offers a coordinated approach to radiosurgery for the treatment
of benign or metastatic brain tumors.
Radiosurgery is not surgery, but is a special, focal form of radiation.
It does not remove the tumor or lesion, but it distorts the DNA
of the tumor cells. The cells then lose their ability to reproduce
and retain fluids.
This treatment allows precisely focused, high-dose radiation beams
to be delivered to a small brain tumor (usually 1½ inches
or less in diameter) in a single treatment session.
Because radiosurgery is radiation and not surgery, the tumor can
be located in an area of the brain or spinal cord that might be
Using special computer planning, this treatment minimizes the amount
of radiation received by normal brain tissue.
If the treatment is delivered in one session, it is called stereotactic
radiosurgery. If it is provided in multiple sessions, it is called
- As a local “boost” following conventional radiation
- For recurrent tumors when the patient has already received
the maximum safe dose of conventional radiation therapy.
- As a substitute for surgery for benign tumors (such as a pituitary,
pineal region or acoustic tumor).
- For metastatic brain tumors.
Stereotactic radiosurgery is limited to the head and neck region
as these areas can be immobilized with skeletal fixation devices
that completely restrict the head’s movement, permitting
the most precise and accurate treatment.
A patient is fitted with a head frame, which also is used during
the treatment planning process when CT and/or MRI scans are done
to obtain information necessary for treatment. Once the planning
is completed, treatment can begin.
Utilizing a linear accelerator-based system, treatment involves
the delivery of a single, high-energy beam that is computer-shaped
to the tumor. The patient is positioned on a sliding bed around
which the linear accelerator circles. The linear accelerator directs
arcs of radioactive photon beams at the tumor. The pattern of the
arc is computer-matched to the tumor’s shape. This reduces
the dose delivered to surrounding normal tissue.
Since stereotactic radiosurgery doesn’t actually remove the
tumor or lesion, shrinking of closing off of the structure occurs
over a period of time, depending on the type of tumor or stage
Radiation kills normal cells as well as tumor cells. Since brain
tissue cannot replace itself, the effects of radiation are cumulative.
Only so many normal cells can be killed before severe results occur.
For this reason, re-treatment with conventional fractionated radiation
is not often recommended.
However, re-irradiation is possible in selected circumstances with
radiosurgery. It depends on the tumor’s location and its
relation to critical brain tissue, when the previous radiation
was given, the amount of radiation originally given, the type of
tumor and the age of the patient.
Metastatic brain tumors may be re-irradiated because the initial
treatment usually involves less than the maximally prescribed dose.
Detailed information on disease-specific treatment is available
under the Patient Information and
Monmouth Medical Center will soon become equipped with Gamma Knife
technology, which has a longstanding record of success in treating
smaller tumors and lesions of the brain.
The Gamma Knife is not a knife at all, but a stereotactic radiosurgical
device that uses multiple beams of radiation that converge in three
dimensions to focus with precision on small tumors in the brain.
As a result, it is able to “cut through” to tumors,
blood vessel malformations and other brain abnormalities located
in the deepest regions in the brain without the risks of open surgery.
The Gamma Knife has been available for 30 years with substantial
research and follow-up studies that demonstrate proven treatment
with successful outcomes.
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Monmouth Medical Center
Disease Site Specific Treatment