The goal of brain tumor treatment is to control tumor growth, alleviate symptoms, prolong patient survival, and preserve neurological function. Treatment plans should be tailored based on tumor type, location, patient age, and overall health. Modern medicine combines surgery, medication, radiation therapy, and other methods, emphasizing multidisciplinary teamwork to improve efficacy and quality of life.
Therapeutic strategies generally fall into three main categories: destroying tumor tissue, inhibiting tumor growth, and relieving associated symptoms. Physicians develop personalized plans based on malignancy grade and staging, with close monitoring of responses and side effects during treatment. Advances such as molecular targeted therapy and immunotherapy offer more precise options for some patients.
Surgery is the cornerstone of brain tumor treatment, primarily aiming to remove the tumor, obtain tissue samples for pathological analysis, and relieve increased intracranial pressure. Microsurgery utilizing high-resolution image-guided technology can precisely delineate tumor boundaries, reducing damage to normal brain tissue. Recent developments like endoscopic surgery and laser ablation are more suitable for deep or functionally critical tumors.
Some patients may undergo subtotal resection to preserve neurological function, with residual tissue treated with radiotherapy or chemotherapy. Surgical risks include bleeding, infection, and neurological deficits, but modern anesthesia and monitoring systems have significantly reduced complication rates. Postoperative pathological staging is often necessary to determine subsequent treatment strategies.
Radiation therapy uses high-energy rays to damage tumor cell DNA and inhibit cell division. Common techniques include stereotactic radiosurgery (such as Gamma Knife), intensity-modulated radiation therapy (IMRT), and proton therapy. Stereotactic methods focus radiation on the tumor area, minimizing damage to surrounding tissues, suitable for well-defined benign tumors.
Innovations like fractionated radiotherapy allow dose adjustments based on tumor shape, while proton therapy’s Bragg peak property enables more precise radiation delivery. Short-term side effects may include headache or fatigue, and long-term effects could impact brain tissue; thus, radiation oncologists must carefully plan dosage and schedule.
Chemotherapy is mainly used for unresectable or highly malignant tumors, such as glioblastoma, where Temozolomide is commonly used as neoadjuvant or adjuvant therapy. Oral and intravenous administration can penetrate the blood-brain barrier and inhibit DNA repair mechanisms. New drug development focuses on targeting specific genetic mutations, such as Ivosidenib for IDH1 mutations.
Chemotherapy may cause hematological toxicity, nausea, and immunosuppression, requiring regular monitoring of blood counts and renal and hepatic functions. Recent research emphasizes drug delivery systems like nanoparticles to precisely target tumors and reduce systemic toxicity.
Targeted therapy aims at specific molecular markers on tumor cells. For example, Bevacizumab inhibits vascular endothelial growth factor (VEGF), blocking tumor angiogenesis. Tyrosine kinase inhibitors like Larotrectinib are used for tumors with specific mutations such as NTRK gene fusions.
Immune checkpoint inhibitors like Nivolumab restore immune response by blocking tumor immune evasion mechanisms, showing efficacy in PD-L1 positive tumors. Combination therapies (e.g., targeted drugs plus immunotherapy) are currently in clinical trials and may become standard treatments in the future.
For tumors located deep or with high surgical risk, radioactive seed implantation can be employed. Iodine-125 or Cobalt-60 particles are placed around the tumor to deliver continuous low-dose radiation, inhibiting growth. Suitable for chordomas or recurrent tumors, this technique requires image-guided placement for accuracy.
TTF is a non-invasive method that uses alternating electric fields at 150 kHz to disrupt tumor cell division. Patients wear a special helmet for over 18 hours daily, often combined with chemotherapy for glioblastoma. This technology has no chemical toxicity but may cause skin irritation or other localized reactions.
Patients should adjust their diet to maintain physical strength, with high-protein foods and omega-3 fatty acids supporting metabolic needs during treatment. Avoiding high-sugar diets can reduce tumor growth stimulation, and supplementing with vitamins E and C may help mitigate oxidative stress.
Physical therapists can design personalized rehabilitation programs including balance training and cognitive exercises. Psychological support such as mindfulness meditation and counseling can effectively address treatment-related anxiety. Family caregivers should learn symptom monitoring skills, such as recognizing sudden motor or speech difficulties.
Gene therapy, which aims to repair abnormal genes or insert tumor suppressor genes, is currently in clinical trials. CRISPR-Cas9 technology can precisely correct mutations like IDH1 but faces challenges crossing the blood-brain barrier. CAR-T cell therapy is under development to train immune cells to recognize tumor antigens.
Nanoparticle drug delivery systems can encapsulate chemotherapy agents within liposomes, accumulating in tumor tissue via the EPR effect. Artificial intelligence applications include analyzing MRI images and genomics data to predict treatment responses and side effects, optimizing personalized therapy plans.
If Karnofsky performance status continues to decline or MRI indicates increased edema around the tumor, multidisciplinary assessment should be promptly arranged. Recurrent tumor patients may need subtotal resection and participation in clinical trials for new drugs, with treatment tailored based on molecular markers.
After brain tumor surgery, patients should avoid strenuous exercise or heavy lifting for at least 6 to 8 weeks and follow rehabilitation recommendations to restore neurological functions. A high-protein, low-salt diet supplemented with omega-3-rich foods like deep-sea fish can promote brain repair. Regular follow-up and emotional support are also crucial to prevent anxiety from affecting recovery.
How can I manage scalp inflammation and nausea during radiation therapy?Use fragrance-free moisturizers to soothe scalp redness and avoid hot blow dryers or heat packs. For nausea, small frequent meals, bland foods, and anti-nausea medications under medical guidance can help. Maintaining oral hygiene with saline rinses every 2 hours can reduce infection risk.
Which types of brain tumors respond well to targeted therapy?Tumors with specific genetic mutations, such as EGFR-mutant glioblastoma or hemangioblastomas, may respond to targeted treatments. Diagnosis involves tissue biopsy and genetic testing to determine suitability, aiming to inhibit tumor angiogenesis or block growth signals. Regular assessment of tumor size and drug tolerance is necessary.
What are early signs of tumor recurrence, and how should patients decide when to seek immediate medical attention?Common signs include new or worsening headaches, blurred vision, limb weakness, or rapid cognitive decline. If symptoms worsen or seizures occur, immediate MRI evaluation is recommended. Patients should keep a symptom diary to assist physicians in rapid diagnosis.
Can patients undergoing chemotherapy also receive acupuncture or traditional Chinese medicine?Some patients may safely use acupuncture to relieve nausea or insomnia under the supervision of healthcare professionals, avoiding needling near treatment sites to prevent bleeding. Herbal medicines should be used cautiously, as some ingredients may interfere with chemotherapy drugs; consultation with the treatment team is essential to ensure safety.
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