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Radiotherapy for Brain Tumours What do I need to know?

Radiotherapy for Brain Tumours What do I need to know?. Dr Matthew Foote Radiation Oncologist Princess Alexandra Hospital Queensland. Topics to cover. What is radiotherapy and how does it work ? What are the different types of radiotherapy and how does this impact on me?

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Radiotherapy for Brain Tumours What do I need to know?

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  1. Radiotherapy for Brain TumoursWhat do I need to know? Dr Matthew Foote Radiation Oncologist Princess Alexandra Hospital Queensland

  2. Topics to cover • What is radiotherapy and how does it work ? • What are the different types of radiotherapy and how does this impact on me? • What are the common side effects ? • What are the most common questions asked by patients and carers? • What is new on the horizon?

  3. What is radiotherapy ? • Effective cancer treatment modality • High energy X-rays damage to tumour cells • Course of radiotherapy (treatment – fraction)

  4. How does it work ? • Ionizing radiation causes DNA breaks • Repair of normal tissue • Fractionation

  5. How does it target my tumour ? • Multiple beams • Complex dose shaping • Sparing surrounding structures

  6. What are the different types of delivery ? • Fractionated • Multiple small doses • Single dose (Radiosurgery)

  7. What are the machines and what does it all mean? • Linear Accelerator (Linac) • Tomotherapy • Gammaknife • Protons

  8. What is a linear accelerator (Linac) ? • Most common machine used to deliver therapeutic radiotherapy • Used for most treatments including brain tumours

  9. What about Tomotherapy ? • Beam as a fan • Similar to CT scan • Ability to spare normal tissue

  10. What about Gammaknife ? • Specific indications • Highly focussed stereotactic (ablative) techniques

  11. What about protons ? • Not currently available in Australia • Specific indications • May be superior in treating some paediatric brain tumours

  12. All of these machine names are confusing so what does it mean for me ? • Each have advantages and disadvantages • May better for treating some tumours • Need to discuss with your radiation oncologist what is the most appropriate.

  13. What is involved in having radiotherapy ? • Specifically for fractionated radiotherapy • Initial appointment • Planning of radiotherapy • Commencement of treatment

  14. Why is there a gap between planning and commencement of radiotherapy ? • Planning process • Use multiple sets of images (MRI) • Mark tumour and all important structures • Design best treatment • Check that the planned dose is what will be delivered • RADIATION THERAPISTS AND PHYSICISTS

  15. What to expect during treatment • Highly variable • Location of brain • Volume that needs to be treated • Radiotherapy dose • Time since operation • Use of chemotherapy • General health factors

  16. ON TREATMENT Tiredness Headaches Nausea Hair loss Skin reddening Hearing difficulties ‘neuro-cognitive’ effects AFTER TREATMENT On going tiredness Hearing difficulties Hormone function Longer term neuro-cognitive effects Most common on treatment effects ? NOT ALL MAY OCCUR AND BEST DISCUSSED WITH RADIATION ONCOLOGIST BASED ON PREVIOUS FACTORS

  17. Other common questions • Effects on carers and children • Can I drive ? • Will I be able to work ? • Do I need someone with me at all times ? • How do we know that the radiation is working

  18. What are some new advances that we should look out for? • Sparing parts of the brain • Enabled due to technological advances in delivery (Intensity Modulated Radiotherapy IMRT, tomotherapy and volumetric modulated arc therapy VMAT)

  19. Other advances in radiotherapy treatment of brain tumours • Utilizing better imaging techniques to better define target and normal tissue

  20. Other advances for the treatment of brain tumours ? • Interaction with targeted chemotherapy agents • bevacizumab (Avastin) • Re-irradiation of brain tumours

  21. Radiotherapy for Brain Tumours • Many changes driven by technology • Important for providers to educate • Active area of research • Better outcomes for patients and family Dr Matthew Foote – matthew_foote@health.qld.gov.au

  22. 5th ANNUAL SCIENTIFIC MEETING 7th – 9th August 2012 Sofitel Hotel Brisbane in conjunction withMedical Oncology Group of Australia ASM (8th-11th August)

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