M. D. Anderson: Setting The Benchmark In Brain Tumor Treatme(3)

Radiation therapy also has been part of the standard of care in brain tumors, but such treatment is especially tricky in the brain, given that tumors are embedded within functional folds of tissue. However, radiation oncologists at M. D. Anderson who specialize in treatment of brain tumors have improved imaging to the point that they can "conform" the beam of therapeutic radiation to match the tumor, says Shiao Woo, M.D., a professor in the Department of Radiation Oncology.

"Instead of treating a large area of brain, we can now use multiple beams to shape radiation around the tumor," says Woo. "This allows us to avoid critical structures and much of the surrounding brain, and that minimizes the treatment's impact on brain functions."

Additionally, a freestanding Proton Therapy Center will open at M. D. Anderson in spring 2006, Offering the most precise form of radiation treatment available. Some brain tumors may be candidates for treatment by the device, which uses a highly focused, pencil-thin beam that stops at the tumor, instead of passing through it as does standard radiation treatment does.

"For brain tumors that are potentially curable, this is the ultimate radiation technology," says James Cox, M.D., a professor and head of the Division of Radiation Oncology.

Moving on with life
Working to reduce post-treatment complications

At the Brain Tumor Center, the focus is on the whole person - not just the tumor.

Brain tumor patients often experience cognitive and functional difficulties as a consequence of traditional therapies and the tumor's proximity to vital functions controlled by that part of the brain. While the removal of a tumor may result in some impairment, chemotherapy and radiation treatments also play a role in hindering a person's ability to think and perform daily activities.

These therapies preferentially affect the outer lining of the nerve fibers of the brain, which serves to insulate and facilitate the transmission of nerve impulses. Patients often become slow and unmotivated. They may have trouble concentrating and remembering, become forgetful and distracted and experience personality changes and mood swings. These effects may be long-lasting and progressive.

M. D. Anderson's neuropsychologists were the pioneers - and are now leaders - in studying the long-term effects of brain cancer in terms of mood and ability to function. "Brain cancer is a disabling condition that causes impairment of real life functions, including poor memory, problems with communication, socially inappropriate behavior and many others," says Christina Myers, Ph.D., a professor in the Department of Neuro-oncology.

"Unfortunately, even subtle impairments of neurobehavioral functioning can reduce the patient's ability to function in his or her usual family and social roles," she says. For example, Meyers says that the majority of brain tumor patients nationwide do not return to work, and many require a full-time or near full-time caregiver.

To help, Meyers and a team of neuropsychologists are assessing risk versus benefit of conventional and investigational agents. They are designing a wide variety of interventions, such as the use of cognitive rehabilitation to help patients compensate for impairments of learning and memory, and cognitive-behavioral therapy to maximize the patients' and their caregivers' adjustment and coping skills. In addition, they are conducting clinical trials that examine the effects of a number of pharmacologic agents to help alleviate neurocognitive symptoms or to protect the brain to avoid them. They are also looking at potential genetic reasons why some brain tumor patients develop more severe neurocognitive symptoms than others, to allow treatment modfications for those that may be at risk.

Until a decade ago, the focus in cancer was to treat and cure the disease. Now we understand that quality-of-life issues are a part of cancer treatment, Meyers says.

"Our overriding goal is to help people be as independent and as high-functioning as possible before and after treatment," she says.

###

Contact: Nancy Jensen
University of Texas M. D. Anderson Cancer Center
(责任编辑：泉水)

搜索

热门标签:

M. D. Anderson: Setting The Benchmark In Brain Tumor Treatme(3)