Brain, Spine, and CNS Tumors Radiation | Advanced Treatment for CNS Cancers

ARC’s commitment to employing cutting-edge technologies and personalized care offers hope and effective treatment solutions for patients facing brain, spine, and CNS tumors.

About Brain, Spine, and CNS Tumors

Brain, spine, and central nervous system (CNS) tumors encompass a variety of malignancies, each with unique characteristics and treatment requirements. Primary brain tumors originate from the cells within the brain itself, such as neural or connective tissues. Conversely, metastatic brain tumors arise from cancer cells that have traveled from other parts of the body to the brain.

Advanced Radiation Centers of New York (ARC) stands at the forefront of treating these complex conditions. ARC is distinguished as the first practice in Long Island and Rockland counties to offer the Trilogy Stereotactic Radiosurgery Accelerator (SRS), marking a significant advancement in precision therapy for CNS tumors. All of our facilities have our linear accelerators equipped with sophisticated “precision-isocenters” that allow for highly conformal, directed and precise beam configurations which are mandatory for tumors in the brain and near vital and sensitive regions of the skull and spine.

Treatment Options

At ARC, the approach to treating brain, spine, and CNS tumors is highly individualized. Often, a neurosurgeon (in the case of brain or spine tumors), or an orthopedic surgeon (in the case of spine tumors) will consider first a surgical excision of the mass; and then this area could be followed by radiation to “mop-up” in some sense any remaining microscopic tumor cells. In other situations, surgery may not be possible or may not be the most appropriate treatment, and radiation as a sole treatment (or perhaps in combination with a systemic treatment like chemotherapy, immunotherapy or an oral agent). In either of these situations, ARC uses the latest in radiation therapy technologies for Brain and Spine tumors that includes:

Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiotherapy (SBRT): Often performed in a single (SRS) or 2-5 (SBRT) treatments this non-invasive and highly sophisticated treatment delivers high-precision, targeted radiation in fewer treatments than traditional therapy and is ideal for treating certain types of brain and spine tumors. Sometimes known as “Cyberknife,” this form of treatment has revolutionized the treatment of many brain and cranial based tumors.
Intensity-Modulated Radiation Therapy (IMRT) and Volumetric Modulated Arc Therapy (VMAT): These techniques allow for the modulation of radiation doses, concentrating the treatment on the tumor while sparing surrounding healthy tissue. Treatments are often spread out, or fractionated, over a number of weeks, to allow a more optimal separation of dose between tumor and normal tissues.

The choice of treatment technology depends on the tumor type, size, location, and the overall health of the patient. ARC’s dedicated team of specialists, including radiation oncologists, medical physicists, and dosimetrists, collaborates to design the most effective treatment plan for each patient.

Side Effects of Brain or Spine Radiation

The first day and even first weeks of radiation are unlikely to produce any noticeable side effects; however, the cumulative effect of radiotherapy can lead to temporary symptoms. Your radiation oncologist may use oral low-dose steroids to help minimize any swelling. Irritation of the scalp or skin could occur, and fatigue may also be noticeable, but it is unlikely to warrant any change in daily activities. These “acute” symptoms as well as any long-term risks of therapy will be discussed with you and your radiation oncologist during your consultation. As well, during the course of radiation, weekly visits with the radiation oncologist are set to assess your response to therapy and discuss any possible side effects.

The Radiation Treatment Process

Radiation treatment demands meticulous preparation by a dedicated team, ensuring precision and patient safety throughout the process. Each step of the radiation treatment process is designed with precision, safety, and your well-being in mind, ensuring that you receive the most effective and personalized care possible.

Consultation

The initial step involves you and your family meeting with an ARC radiation oncologist to discuss your diagnosis, review your medical history, and consider the most effective radiation treatment options tailored to your specific case. Expectations of therapy, side effects and treatment alternatives will be discussed.

Simulation

Once a course of radiation is agreed upon a simulation, or treatment planning session is performed over a 45-60 minute period. During the simulation, the positioning of the body is set, often used a thermoplastic “mask” which is customized to the head/face area and ensures daily reproducibility in positioning on a day-to-day basis, aiding in pre-treatment alignment. An imaging scan is performed to pinpoint the exact location of the cancer or areas at risk relative to the geometric position of the body and treatment room. This step is crucial for designing a treatment plan that maximizes the radiation dose to the cancer while sparing surrounding healthy tissue.

The Planning Process (Behind the Scenes)

For a week or two following the simulation, a multi-disciplinary team composed of the radiation oncologist, medical physicists, and dosimetrists, collaborate behind the scenes using advanced software to 3-dimenionally reconstruct the anatomic areas of consideration and map out the precise treatment plan, calculating the optimal radiation dose distribution. This dosimetry plan is a “blueprint” that will be used to ensure accuracy in the treatment delivery.

Daily Radiation Treatments

Radiation therapy typically involves daily treatments over several weeks using a machine that generates high energy photons called a linear accelerator. The treatment room is large and is not claustrophobic. Each session typically takes place in a 10-15 minute appointment slot, with most of this time used in positioning and alignment, while the actual beams of radiation are on for only a few minutes. The radiation is invisible and not felt. Patients can drive themselves to and from the appointments, continue to work or exercise and maintain their normal daily activities. Specific restrictions, if any, can be discussed with your radiation oncologist at consultation and during the weekly on-treatment visits.

Weekly On-Treatment Physician Review

Regular meetings with patients undergoing radiation are conducted with the radiation oncologist throughout your treatment course. These check-ins allow the doctor to monitor your progress, briefly exam the area under treatment for any possible side effects, provide any medications or treatment adjustments, and discuss any questions or concerns that may arise during therapy.

Completion of Therapy and Follow-Ups

Upon finishing the radiation treatment course, a final conversation with your radiation oncologist will discuss the next steps, expectations for resolution of side effects, and any further treatment or monitoring needed. Regular follow-up appointments are crucial after completing radiation therapy, and allow the radiation team to monitor your recovery, manage any late side effects, and check for signs of cancer recurrence.