Tumours of the brain and skull base

Proton therapy in the treatment of brain tumours

The brain is the most complex and important organ in the human body. It is the centre of all mental, motor, and sensory activities and coordinates the vital functions.

There are various complications when irradiating brain tissue in the presence of tumour cells. In fact, there is a very high risk of damaging sensitive structures found very close to the tumour such as brain tissue, eyes, optic nerves, and hearing centres.

While photon radiation interventions (radiation therapy) can cause damage, permanent complications, and, in some cases, impact the patient’s quality of life, proton beam therapy reduces the risks and thus the complications due to the possibility of precisely controlling the radiation area.

The advantages of proton beam therapy

Proton therapy is a treatment that allows extremely precise channelling of the maximum energy in a narrow area. Unlike traditional radiation therapy techniques, this allows intervention on tumour cells, eliminates the impact the treatment could have on adjacent tissues, and protects the surrounding healthy organs.

Proton beam therapy may be used to intervene more decisively on the tumour without increasing the risk of damaging healthy tissue. This treatment is particularly suited to primitive pathologies (originating directly in the brain or in the skull base) with a low degree of aggressiveness, which show treatment potential and a long life expectancy. Plus, it can also be used effectively in cases in which the illness is aggressive and it is necessary to intervene to control the tumour cells and their growth, or when, in cases of recurrence and progression, it is necessary to repeat a treatment.

On the contrary, in cases of pathologies with an extremely limited life expectancy - as in malignant primitive tumours and secondary ones, or tumours originating in other parts of the body - the advantages of proton therapy can be less significant, and the potential benefits must be evaluated on a case by case basis.

Treatment: proton therapy and brain neoplasms   

The choice of the most suitable treatment for brain and skull base neoplasms is influenced by various factors such as the type of tumour, degree of aggressivity, disease site, extension, and the patient’s age and medical condition.

These neoplasms involve various medical professionals who, together, make up a multidisciplinary group including a neurosurgeon, oncologist, radiation oncologist, neurologist, neuroradiologist, and anatomo-pathologist, who will develop a specific treatment plan based on the characteristics of each individual patient.

The various individuals involved are indispensable in order to face the difficulties posed by this type of cancer, which are particularly linked to the need to resort to sophisticated and high-precision surgical and radiation techniques, the reduced possibility of intervening with pharmacological treatments, and the potential toxicity of the treatments.

For primitive and secondary brain and skull base tumours, the surgical, radiation, and chemotherapy interventions may be combined or used separately.

The Trento Proton Therapy Centre evaluates and performs:

treatment of primitive tumours of the brain and low-grade skull base tumours in initial diagnosis:

• low-grade gliomas
• ependymomas
• medulloblastomas
• meningiomas
• schwannomas
• pituitary adenomas
• chordomas
• chondrosarcomas
• craniopharyngiomas
• other rare pathologies

treatment of primitive tumours of the brain and low-grade skull base tumours in initial diagnosis, excluding glioblastomas:

• meningiomas
• anaplastic gliomas
• other rare pathologies

The treatment of recurrences of high and low-grade primitive brain tumours, after a previous radiation treatment:

• glioblastomas
• low-grade gliomas
• anaplastic gliomas
• ependymomas
• medulloblastomas
• meningiomas
• schwannomas
• pituitary adenomas
• chordomas
• chondrosarcomas
• craniopharyngiomas
• other rare pathologies