Benign brain tumors Radiotherapy

Procedure

Radiation therapy focuses high-energy X-rays on the brain tumor or any remaining tumor cells inside the brain or at the base of the skull in order to destroy them 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 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, radiation therapy for small tumor foci can be performed as radiosurgery in a single session or a few sessions, or, for larger tumors, as fractionated stereotactic radiation therapy over several weeks. Close and personal support is a matter of course for us.

The Department of Radiation Oncology at the USZ uses only the most advanced techniques for the precise treatment of brain tumors with minimal side effects. They are being cared for by nationally and internationally renowned experts in the research and treatment of these tumors: Prof. N. Andratschke and Dr. M. Brown.

For many patients, we are already offering the treatments of tomorrow: through clinical trials, we are constantly working to improve the treatment of brain tumors to make them even more effective and better tolerated. You can find an overview of the currently open studies here.

There are various types of benign brain tumors. The most common tumors that we, as radiation oncologists, evaluate and treat are meningiomas, vestibular schwannomas, and pituitary adenomas.

In the following, we will describe radiation therapy for various types of benign brain tumors.

• Meningiomas
• Vestibular schwannomas
• Pituitary adenomas

Radio-oncological treatment of meningiomas

Meningiomas are tumors that originate in the meninges and can be classified into three pathological grades based on their growth pattern and aggressiveness: Grade 1 (benign), Grade II (atypical), and Grade III (malignant).

In cases of meningiomas, the goal should always be to achieve the most complete surgical removal possible.

For Grade I–II meningiomas, stereotactic radiation therapy is an excellent, noninvasive treatment option. Stereotactic radiation therapy can very effectively prevent further tumor growth and, over the long term, also shrink the tumor—often in areas that are difficult to access surgically and where vital structures (such as the optic nerves or the pituitary gland) are located. Radiation therapy is typically administered over a period of 5–6 weeks with daily treatments to ensure optimal and gentle treatment. For very small tumors, stereotactic radiosurgery (in 1–5 sessions) may be an option

Postoperative radiation therapy is always indicated for Grade II meningiomas that could not be completely removed and for Grade III meningiomas, as progressive growth or recurrence is otherwise very common.

Radiation therapy is administered over a period of 5.5 to 6 weeks with daily treatments to ensure optimal and gentle treatment.

Through clinical trials, we continue to work toward improving the treatment of benign brain tumors to make it even more effective and better tolerated. You can find an overview of the currently open studies here.

Radio-oncological treatment of vestibular schwannomas

Vestibular schwannomas are benign tumors that originate in the nerve sheath of the eighth cranial nerve (the vestibulocochlear nerve). Common symptoms often include hearing loss, dizziness, or balance problems. Treatment depends on various factors, such as the size of the tumor, the patients’ age, and their underlying medical conditions, as well as the patients’ preferences.
There are two equally effective treatment options that differ in their side effects: stereotactic radiation therapy and surgery. Stereotactic radiation therapy is noninvasive, does not require hospitalization, and is very well tolerated. The chances of success for local tumor control are over 90 percent—and over 95 percent for very small tumors—making it comparable to surgery in terms of effectiveness.

It is important that an interdisciplinary consultation and evaluation be conducted by experts in radiation oncology, the Head, Neck, and Ear Clinic, and neurosurgery, and that all options be discussed with you. Stereotactic radiosurgery (1 session), stereotactic radiation therapy (up to 5 sessions), or fractionated stereotactic treatment (up to 30 sessions) is discussed in detail and on an individual basis at the Department of Radiation Oncology. A treatment regimen consisting of only 1–5 sessions is suitable for smaller tumors, typically less than 1.5 cm in size and without extensive contact with the brainstem.

Through clinical trials, we continue to work toward improving the treatment of benign brain tumors to make it even more effective and better tolerated. You can find an overview of the currently open studies here.

Radio-oncological treatment of pituitary adenomas

Pituitary adenomas are benign tumors that originate in the pituitary gland. A distinction is made between secretory (hormone-producing) and nonsecretory (non-hormone-producing) pituitary adenomas. Pituitary adenomas are treated differently depending on their type (secretory or nonsecretory), size, and symptoms, and are therefore always evaluated and treated through an interdisciplinary approach. Experts in endocrinology, neurosurgery, and radiation oncology will be in attendance. Depending on the situation, stereotactic radiosurgery (up to 5 sessions) or fractionated stereotactic radiotherapy (up to 30 sessions) may have been offered as an important part of the treatment plan. For tumors that cannot be treated surgically, stereotactic radiation therapy is a treatment option as the primary treatment.

Stereotactic radiation therapy is a scientific and, in particular, clinical focus of our clinic.

Through clinical trials, we continue to work toward improving the treatment of benign brain tumors to make it even more effective and better tolerated. You can find an overview of the currently open studies here.