Common symptoms like headaches, vomiting, loss of

orientation, etc. could indicate the presence of a brain

Tumour

A brain tumour is an abnormal growth of cells within the brain. It

arises from glial cells of the brain, lymphatic tissues, nerves and

meninges. Benign brain tumours grow slowly but they can

compress adjacent parts of the brain. Malignant tumours grow

rapidly and they invade adjacent structures of the brain. Brain

tumours are graded according to the nature of cell growth.

Grade I and II tumours are grouped as low-grade, whereas

grade III and IV are grouped as high-grade tumours. Prognosis

is better in low-grade or benign tumours.

The following types of Brain Bumours are seen commonly:

•In Children: Juvenile pilocytic astrocytoma, craniopharyngioma, medulloblastoma,

brainstem glioma and germ cell tumours.

•In Adults: Astrocytoma, oligodendroglioma, ependymoma, meningioma, vestibular

schwannoma and lymphoma. Cancers from other parts of the body can also spread to

brain.

•Headaches, usually in the morning

•Vomiting

•Convulsions or seizures

•Weakness in Limbs

•Loss of balance while walking

•Altered Speech or Vision

•Altered Behaviour

•Loss of Orientation

•Memory Lapses

What are the Common Symptoms of Brain Tumours?

How are Brain Tumours Diagnosed?

Imaging: CT scan or MRI scan of brain is commonly performed.

In Adults: Astrocytoma, oligodendroglioma, ependymoma, meningioma, vestibular

schwannoma and lymphoma. Cancers from other parts of the body can also spread

to brain.

Biopsy: A piece of tumour is removed for examination by open surgery or in

stereotactic fashion using rigid frame to fix skull and localizing tumour under

guidance of CT scan or MRI.

How are Brain Tumours Treated? Brain tumours are treated by surgery, radiation therapy or

chemotherapy, or a combination of these. The choice of

treatment depends upon the age of the patient, type of

tumour, its location, size and grade.

Surgery: Maximum safe resection of the tumour or at least a

biopsy is the standard goal of surgery.

Radiation therapy: Radiation kills tumour cells with high

energy X-rays, gamma rays or protons. It is usually started

after surgery and given over 5-6 weeks.

Chemotherapy: Chemotherapy is the use of drugs to kill

cancer cells. It is given orally or through veins. It is given

concomitantly with radiation therapy in high-grade tumours.

It is also given in recurrent brain tumours after failure of

initial treatment.

What are the Advances in Radiation Therapy of Brain Tumours?

3-Dimensional Conformal Radiation Therapy (3D-CRT) and Intensity Modulated

Radiation Therapy (IMRT): CT scan and MRI are used to delineate the tumour and

computers are used for radiation planning. Only the tumour and the high-risk region

surrounding the tumour is radiated, avoiding radiation to the normal structures in the

brain.

Stereotactic Radio-surgery (SRS) and Stereotactic Radiotherapy (SRT): Highly precise

immobilization and image guidance system is used for treatment of selected brain

tumours. High dose of radiation is delivered only to the tumour with very minimal spillage

of dose to the rest of the sensitive brain structures. Stereotactic radiotherapy is preferred

in children. Stereotactic radio-surgery delivering high-dose of radiation in single or a very

few sessions is performed in adults with tumours such as metastatic residual glioma,

meningioma and schwannoma. Novalis-Tx and Cyberknife are advanced machines to

deliver such high-precision therapy.

What are the Advances in Radiation Therapy of Brain Tumours?

High-definition Rapid Arc: This is the latest software advancement in radiation planning

technology. Radiation is delivered in continuous fashion moving the machine head and its

small components simultaneously around the patient's head targeting the tumour by

infinite small radiation beams. Radiation treatment with such a technique is highly precise

and fast. This is preferred in children and elderly patients who cannot lie on treatment

couches for long periods.

Proton beam therapy: Proton therapy avoids spillage of radiation dose to the surrounding

brain. It is preferred in children as well as in patients with recurrent tumours who have

received radiation therapy earlier.

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