The treatment goals for brain tumors are to control tumor growth, alleviate symptoms, prolong patient life, and maintain neurological function. Treatment plans must be tailored according to the type and location of the tumor, the patient's age, and overall health status. Modern medicine combines various methods such as surgery, medication, and radiation, emphasizing multidisciplinary teamwork to enhance efficacy and quality of life.
Treatment strategies are typically divided into three main directions: destroying tumor tissue, inhibiting tumor growth, and alleviating related symptoms. Physicians will develop individualized plans based on the degree of malignancy and staging, closely monitoring responses and side effects during treatment. Emerging technologies such as molecular targeted therapy and immunotherapy offer more precise treatment options for some patients.
Surgery is the core method for treating brain tumors, with primary goals including tumor removal, obtaining tissue samples for pathological analysis, and alleviating increased intracranial pressure. Microsurgery utilizes high-resolution imaging navigation technology to accurately locate tumor boundaries, minimizing damage to normal brain tissue. Recently developed endoscopic surgery and laser ablation techniques are more suitable for deep or functional area tumors.
Some patients may undergo "subtotal resection" to protect neurological function, with residual tissue requiring adjunctive radiation or chemotherapy. Surgical risks include bleeding, infection, and neurological deficits, but modern anesthesia and monitoring systems have significantly reduced complication rates. Post-surgery, pathological staging is often required to determine subsequent treatment directions.
Radiation therapy uses high-energy rays to destroy tumor cell DNA and inhibit division. Common techniques include stereotactic radiosurgery (such as Gamma Knife), intensity-modulated radiation therapy (IMRT), and proton therapy. Stereotactic techniques can concentrate doses in the tumor area, reducing damage to surrounding tissues, making them suitable for well-defined benign tumors.
New forms of "fractionated radiation therapy" can adjust dose distribution based on tumor shape, while proton therapy, due to the Bragg peak characteristics of charged particles, allows for more precise control of radiation range. Radiation therapy may cause short-term headaches or fatigue and could have long-term effects on brain tissue, thus requiring strict planning of doses and schedules by radiation oncologists.
Chemotherapy is primarily used for tumors that cannot be surgically removed or are highly malignant, such as glioblastoma, which often uses "Temozolomide" for preoperative or postoperative adjuvant therapy. A combination of oral medications and intravenous injections can penetrate the blood-brain barrier and inhibit DNA repair mechanisms. New drug development focuses on medications targeting specific gene mutations, such as "Ivosidenib" for IDH1 gene mutations.
Chemotherapy may cause hematologic toxicity, nausea, and immunosuppression, necessitating regular monitoring of blood cell counts and liver and kidney function. Recent research has focused on "drug delivery systems," using nanoparticles to precisely deliver drugs to tumor areas to reduce systemic toxicity.
Targeted therapy focuses on unique molecular markers present in tumor cells, such as "Bevacizumab," which inhibits vascular endothelial growth factor (VEGF) to block tumor angiogenesis. Tyrosine kinase inhibitors targeting specific gene mutations (such as Larotrectinib) have also been applied to specific types like schwannomas.
Immune checkpoint inhibitors like "Nivolumab" show efficacy against PD-L1 positive tumors by releasing tumor immune evasion mechanisms. Combination therapy strategies (such as combining targeted drugs with immunotherapy) are currently in clinical trial stages and may become standard treatments in the future.
For deeply located or high-risk surgical tumors, "radioactive particle implantation" can be used. Iodine-125 or cobalt-60 particles are placed around the tumor to suppress growth through continuous low-dose radiation. This method is suitable for chordomas or recurrent tumors and requires imaging navigation to ensure precise particle distribution.
"Tumor Treating Fields" (TTF) is a non-invasive method that uses alternating electric fields at a frequency of 150 kHz to disrupt tumor cell division. Patients must wear a special helmet for more than 18 hours daily, often used in conjunction with chemotherapy for glioblastoma patients. This technique has no chemical toxicity but may cause local reactions such as skin irritation.
Patients need to adjust their diet to maintain physical condition, with a high-protein diet combined with omega-3 fatty acids to support metabolic needs during treatment. Avoiding high-sugar diets can reduce tumor growth stimulation, and supplementing with vitamins E and C can alleviate oxidative stress.
Physical therapists will design customized rehabilitation programs, including balance training and cognitive function exercises. For psychological support, mindfulness meditation and supportive counseling can effectively address treatment-related anxiety. Family caregivers need to learn symptom monitoring skills, such as observing sudden motor disturbances or speech difficulties.
Gene therapy aims to repair abnormal genes or insert tumor suppressor genes and is currently in clinical trial stages. The CRISPR-Cas9 system can precisely repair IDH1 gene mutations, but the issue of penetrating the blood-brain barrier remains to be solved. Immunotherapy's "CAR-T cell therapy" is under development, aiming to train autologous immune cells to recognize tumor antigens.
Nanodrug delivery technology can encapsulate chemotherapy drugs in liposomes, accumulating in tumor tissues through the EPR effect. Artificial intelligence is applied in treatment planning, with AI algorithms analyzing MRI images and genomic data to predict response rates and side effect risks for different treatments.
If a patient experiences a continuous decline in Karnofsky performance status after treatment, or if MRI shows an expanded area of edema around the tumor, a multidisciplinary evaluation should be arranged immediately. Patients with recurrent tumors may need to participate in new drug clinical trials after subtotal resection, with physicians selecting appropriate agents based on molecular markers.
After brain tumor surgery, patients should avoid vigorous exercise or heavy lifting for at least 6 to 8 weeks and follow physician recommendations for rehabilitation training to restore neurological function. A diet high in protein and low in salt is recommended, along with foods rich in Omega-3, such as deep-sea fish, to promote brain repair. Regular follow-up examinations and emotional support are also important, as anxiety can affect recovery progress.
How can patients alleviate side effects such as skin inflammation and nausea during radiation therapy?During radiation therapy, fragrance-free moisturizers can be used to relieve redness and swelling of the scalp, and patients should avoid using excessively hot hair dryers or heat packs. Nausea can be managed through small, frequent meals, choosing light foods, and using anti-nausea medications under physician guidance. Maintaining oral hygiene can also reduce infection risks, with recommendations to rinse with warm salt water every 2 hours.
What types of brain tumors may respond effectively to targeted drug therapy?Brain tumors with specific genetic mutations (such as EGFR mutations in glioblastoma) or vascular tumors may respond to targeted therapies. Physicians will determine eligibility through tissue biopsies and genetic testing, with treatment goals aimed at inhibiting tumor angiogenesis or blocking cancer cell growth signals. Regular assessments of tumor shrinkage and drug tolerance are necessary.
What are the early signs of brain tumor recurrence? How should patients determine if they need immediate medical attention?Common signs of recurrence include new patterns of headaches, blurred vision, limb weakness, or rapid cognitive decline. If existing symptoms worsen (such as occasional dizziness turning into persistent imbalance) or seizures occur, patients should seek immediate medical attention for an MRI examination. Patients should document the timing and frequency of symptom onset to assist physicians in making quick assessments.
Can brain tumor patients undergoing chemotherapy simultaneously receive acupuncture or traditional Chinese medicine to alleviate symptoms?Some patients may use acupuncture to relieve nausea or insomnia under the supervision of both a qualified traditional Chinese medicine practitioner and an oncologist, but need to avoid needling near the treatment area to prevent bleeding risks. The use of herbal medicine should be approached cautiously, as certain components may affect chemotherapy drug metabolism, and safety must be confirmed with the treatment team first.
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