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What are the different external radiation therapy techniques used to treat brain cancer?
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RobertLustigMD (Physician - Oncology - Radiation (Verified) ) - 06 / 22 / 2012
There are a number of pieces of equipment that can deliver external radiation. The most common piece is a linear accelerator. This machine delivers x ray beams of 6MV(low energy) or 10-18MV(high energy). There are a number of treatment planning methods to deliver x rays. The simplest is 3 D conformal. Usually 2 to 4 beams are used and the entire target is treated by each beam. The fields can be shaped using the multileaf collimator which is attached to the machine head or by lead blocks which can be constructed and attached to the machine. IMRT (intensity modulated radiation therapy) is a more complex treatment plan. In additional to designating targets to be treated, targets to be avoided are contoured. Dose limits are then given for these organs. In IMRT 5 to 9 treatment fields are used. However, some fields may treat only a part of the tumor or the leaves on the collimator may move during treatment to differentially dose the target. Rapid arc is the use of the rotating gantry head and the simultaneous motion of the collimator leaves to shape the field. Brain tumors are generally treated daily for 6 to 7 weeks.
Gamma Knife uses 201 fixed Cobalt60 sources all aimed at a central point. These can be adjusted for size using collimators with openings as small as 0.4cm. The patient’s head is fixed in a frame and adjusted in the machine to focus the beams at the target. Usually multiple “shots” are given to the target. The treatment is given in one session.
The Cyberknife is a small 6MV linear accelerator mounted on a robotic arm. The machine also has built in x rays to track the position of the head. The radiation can be delivered through multiple non-coplanar angles and has the ability to shape the treatment to fit the tumor. Generally one to five treatments are used with a higher dose per treatment then standard therapy.
Protons are generated from a cyclotron. Protons are particles and only go a finite distance before disintegrating and depositing their energy. Protons can be delivered from a fixed beam or from a rotating gantry. The depth of treatment can be adjusted by manipulating the beam after it leaves the cyclotron. The advantage of protons is protection of normal brain tissue.
Gamma Knife uses 201 fixed Cobalt60 sources all aimed at a central point. These can be adjusted for size using collimators with openings as small as 0.4cm. The patient’s head is fixed in a frame and adjusted in the machine to focus the beams at the target. Usually multiple “shots” are given to the target. The treatment is given in one session.
The Cyberknife is a small 6MV linear accelerator mounted on a robotic arm. The machine also has built in x rays to track the position of the head. The radiation can be delivered through multiple non-coplanar angles and has the ability to shape the treatment to fit the tumor. Generally one to five treatments are used with a higher dose per treatment then standard therapy.
Protons are generated from a cyclotron. Protons are particles and only go a finite distance before disintegrating and depositing their energy. Protons can be delivered from a fixed beam or from a rotating gantry. The depth of treatment can be adjusted by manipulating the beam after it leaves the cyclotron. The advantage of protons is protection of normal brain tissue.
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