Procedure
Radiotherapy focuses high-energy X-rays on the tumor in order to kill it in a targeted manner. Depending on the tumor situation, radiotherapy is either an equivalent alternative to surgery or is used when surgery is not possible.
Radiotherapy can also be used if a non-brain tumor has already spread to the brain and brain metastases have developed: radiotherapy can then be used to specifically kill these metastases through radiosurgery without the need for surgery (palliative radiotherapy).
Radiotherapy is carried out as an outpatient treatment, is non-invasive (i.e. does not require anesthesia) and can therefore be easily integrated into everyday private and professional life. Depending on the extent of the tumor, radiotherapy can be carried out in one or a few treatment sessions as radiosurgery for small tumor foci, or as fractionated treatment over several weeks for larger tumors. Radiotherapy is often combined with chemotherapy to improve its effectiveness or is an important component of a treatment concept comprising surgery, chemotherapy and radiotherapy. Close and personal support is a matter of course for us.
Radiotherapy procedure
The Department of Radiation Oncology at the USZ uses only the most modern techniques for the precise and low side-effect irradiation of brain tumors and brain metastases. They are supervised by nationally and internationally renowned experts in the research and treatment of these tumors.
For many patients, we are already offering the treatment of tomorrow: in clinical trials, we are continuously working on improving the treatment of brain tumors and brain metastases to make it even more effective and tolerable. You can find an overview of the currently open studies here.
Radio-oncological treatment of low- and high-malignant brain tumors
Radiotherapy of brain tumors, so-called gliomas, is usually integrated into a so-called multimodal therapy concept: It begins with surgery to obtain an accurate diagnosis, followed by radiotherapy and drug therapy (usually chemotherapy) to prevent the tumor from recurring in the resection area. The oncological decision as to whether and how these therapies should be optimally used and timed is discussed and determined for each patient in an interdisciplinary tumor board after all relevant factors have been taken into account: Imaging results, type of cancer and molecular tests if tumor tissue is present, age and secondary diseases as well as the patient’s expectations and wishes.
Low-malignant brain tumors (gliomas)
These types of tumors are slow-growing and are operated on in the first stage of treatment. If an operation is not possible, in selected situations only a tissue sample is taken. If treatment is deemed necessary by the tumor board, radiotherapy is usually followed by chemotherapy. This treatment can extend the life expectancy of patients. Radiotherapeutic treatment usually takes place every working day for 5.5 weeks and is well tolerated without any major side effects. Chemotherapy is usually given afterwards, approximately one month after the end of radiotherapy.
Highly malignant brain tumors (glioblastomas)
Highly malignant brain tumors are fast-growing, aggressive tumor types and require combined treatment by an interdisciplinary team. Combined radiochemotherapy is carried out after the operation or in selected cases – for example, if an operation is not possible – only after a tissue sample has been taken. This is usually followed by a continuation of chemotherapy, which is generally very well tolerated. Depending on the patient’s age and general condition, combined radiochemotherapy is given over 6 weeks or – in older patients – over just 3 weeks. In selected situations, either radiotherapy alone for 3 weeks or chemotherapy alone may be considered.
Image-guided high-precision radiotherapy is planned and carried out on the basis of state-of-the-art imaging, so that healthy brain tissue and cancerous tissue can be optimally differentiated. This allows us to define exactly which areas should be irradiated and which organs should be spared. Intensity-modulated radiation planning allows us to adjust the radiation individually for each patient and achieve an accuracy in the millimeter range.
Image-guided high-precision radiotherapy is a clinical and scientific focus of our clinic: Prof. N. Andratschke was instrumental in developing this methodology and we pass on our knowledge in a large number of international courses and congresses. We are active as international experts in guideline commissions. State-of-the-art equipment and experienced medical physicists and MTRAs contribute to treatment of optimum quality and safety.
Radio-oncological treatment of brain metastases
Brain metastases are cancer metastases in the brain that can occur in the course of aggressive types of cancer, such as lung cancer, melanoma or certain forms of breast cancer. Radiotherapy is a highly effective method with few side effects that can safely kill these metastases and prevent or treat further complications that can be triggered by the metastases. This is often done in combination with chemotherapy, immunotherapy or other targeted therapy.
Today, brain metastases are treated at our center for most patients by means of a single high-dose radiation treatment: this is called radiosurgery. The smaller the metastases are and the earlier they are irradiated, the better the results. We have further developed this therapy so that we can usually treat a larger number of brain metastases safely and effectively.
Radiosurgery of brain metastases is a clinical and scientific focus of our clinic and of Prof. N. Andratschke and Prof. M. Guckenberger. We pass on our knowledge in a large number of international courses and congresses. We are active as international experts in guideline commissions. State-of-the-art equipment and experienced medical physicists and MTRAs contribute to treatment of optimum quality and safety.
At the same time, we work closely with our colleagues in medical oncology to guarantee “one-stop” treatment. We also consult with our colleagues in palliative medicine at an early stage.
In clinical trials, we are continuously trying to improve the treatment of brain metastases in order to make it even more effective and tolerable. You can find an overview of the currently open studies here.
