Radiotherapy for Brain Tumors

Brain Tumor Center First in Nation with the Latest Proton Therapy Technology

A multidisciplinary approach to brain tumors combining state-of-the-art surgical techniques, radiation therapy — including the latest advances in intensity modulated proton therapy — and drug therapies draws patients from all over the globe to University of Maryland Greenebaum Cancer Center. Here each patient benefits from a customized care plan focused on maximizing positive outcomes while minimizing side effects and promoting overall quality of life.

The Brain Tumor Center’s international reputation for excellence — while remaining a hub for the toughest local and regional cases — stems in large part from the unique collaboration of subspecialists in neurosurgery, neuro-oncology, neuropathology, neuroradiology and radiation oncology, who hold weekly multidisciplinary conferences to discuss each patient’s case and staff a multidisciplinary clinic where patients consult with several physicians at each visit. Dozens of types of malignant and benign brain tumors are treated here, ranging from glioblastomas to astrocytomas to neuromas, chordomas and more.

“We have a broad, outstanding team of experts, including surgical teams that specialize in treating tumors that affect the skull base and pituitary gland where the interplay between the anatomy of the face, neck, and head is very important,” says neurosurgeon Graeme Woodworth, M.D., director of neurosurgical oncology and an assistant professor of neurosurgery at the University of Maryland School of Medicine. “Our team is a cohesive, experienced group that discusses each patient from a holistic, integrated standpoint, also entertaining the options for clinical trials when appropriate. Our goal is to effectively combine the best available treatment options with the needs and condition of the patient and loved ones.”

Brain Tumor Program with Combined Modality Approach

Most malignant brain tumors are tackled with an evidence-based approach incorporating surgical, radiation and drug therapies at various stages of treatment. Before and during surgery, advanced technologies such as functional MRI scans, brain mapping and “awake” procedures are performed to precisely define not only the location of a tumor, but to minimize the risk of damaging critical structures important for a patient’s speech, vision or mobility, Dr. Woodworth says.

Radiation therapy is matched to each patient’s individual case and includes cutting-edge techniques such as stereotactic radiosurgery, image-guided radiation therapy (IGRT), intensity-modulated radiation therapy (IMRT) and brachytherapy, among others.  “Radiotherapy technology used here is second to none,” says radiation oncologist Minesh Mehta, M.B. Ch.B, Associate Director of Clinical Research and professor in the Department of Radiation Oncology. 

Beginning in 2015, the very latest technological advances in the field of cancer-fighting radiation delivery will be available to patients at the Greenebaum Cancer Center when the Maryland Proton Treatment Center opens on campus in the adjacent University of Maryland Biopark. This center will be the first in the nation to have the latest in proton therapy technology (intensity modulated proton therapy {IMPT} using pencil beam scanning with on-board volumetric image-guidance) integrated into all of the beam lines from inception.  Proton therapy has shown great promise in the treatment of brain, skull-base and paraspinal tumors, and is particularly valuable for pediatric brain and spinal tumors, the most common solid tumor in children. IMPT has the ability to precisely target the tumor while reducing exposure to other areas of the body, and this is especially critical in the treatment of children, who are at high risk for the side effects from traditional radiation therapy approaches. 

Both Dr. Mehta and Young Kwok, M.D., associate professor in the Department of Radiation Oncology, have earned national recognition for their expertise in treating children with radiation therapy. The Greenebaum Cancer Center has become a regional referral center for offering current state-of-the-art radiation therapy for pediatric cancer patients, including from the Children's National Medical Center in Washington D.C. 

Radiology and pathology specialists provide crucial support for brain tumor care, Drs. Woodworth and Mehta agree. Augmenting these efforts is a new collaborative venture between the University of Maryland School of Medicine, University of Maryland Medical Center and industry partners to create a Center for Integrated Metabolic Imaging & Therapeutics (CIMIT), which will promote the translation of new technologies using hyper-polarization for metabolic pathway imaging and focused ultrasound for non-invasive treatments in the brain and spine. “We see these exciting technologies as having great potential in the near-term for our brain tumor patients,” Dr. Woodworth says.  

Innovative Research

Complementing aggressive efforts to treat brain tumor patients at Greenebaum Cancer Center are a host of promising clinical trials that allow physicians to expand their knowledge of the various forms of disease. “Patients view it as a state-of-the-art program where all of the modern options are available to them,” Dr. Mehta notes. 

Current clinical trials targeting brain tumors include:

  • Combining low-dose, whole-brain radiotherapy with standard chemotherapy drugs (TMZ regimen) to determine its effectiveness in treating microscopic tumor stem cells that are outside the area of the brain receiving partial-brain radiotherapy, and are postulated to be the source of tumor regrowth after conventional treatment.
  • Comparing re-irradiation of the brain with bevacizumab versus the use of bevacizumab alone — bevacizumab inhibits the formation of new blood vessels feeding brain tumors, and its combination with re-irradiation is being tested in a national study, given the synergy between these two approaches.
  • Adding everolimus — a targeted anti-cancer therapy traditionally used for advanced kidney cancer — to traditional glioblastoma treatment combining surgery, radiation therapy and temozolomide, a standard chemotherapy for glioblastomas, to determine if it will improve survival or delay cancer growth.

For more information, please call 1-800-373-4111. This OneCall number gives physicians immediate access to a senior UMGCC oncology attending physician, 24 hours a day, seven days a week.

This page was last updated: February 4, 2014

         
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