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Winter 2007

Brain Tumor Options Hold Promise

Recent advances at UCLA in surgical and postsurgical treatments for malignant brain tumors are bringing promising new options to patients for a cancer that has traditionally been among the most difficult to treat.

“A diagnosis of brain tumor should never be considered a hopeless situation. More options are available for these patients than ever before,” says Linda Liau, M.D., Ph.D., UCLA neurosurgeon, who helped develop a brain tumor vaccine.

Brain cancer, diagnosed in approximately 20,000 people each year in the United States, is typically treated with a combination of surgery and adjuvant therapy—including radiation, chemotherapy and, more recently, targeted agents and other approaches tested in clinical trials. The challenge for surgeons has been to remove as much of the tumor as possible while operating in difficult-tonavigate sites, and without interfering with critical areas that affect language and motor skills. “Studies have shown that the less tumor we leave behind in surgery, the better patients do, because the subsequent adjuvant treatment can be more effective,” Dr. Liau says.

Improved imaging techniques, used at major centers such as UCLA, make it easier for surgeons to remove more of the tumor. Experts at the UCLA Brain Mapping Center use functional magnetic resonance imaging (fMRI) to provide surgeons with three-dimensional maps showing tumor location and areas that affect language and motor functions. Diffusion tensor imaging, a newer technique that maps out the brain’s white matter, enables surgeons to remove tumor cells they could not navigate using traditional MRI. These technologies can be incorporated at the time of surgery with intra-operative MRI.

“These techniques give us a GPS system for the brain, allowing us to feel more confident during the surgery about where we are, and how to get to where we need to go,” Dr. Liau says.

Advances are also being made in adjuvant treatments. Computer guidance helps radiation therapists go further in safely killing brain tumor cells than they could in the past. With less residual disease from better surgery and radiation, chemotherapy drugs are more likely to be effective. So-called targeted agents, many of them available only through clinical trials, tend to be less toxic than traditional chemotherapy drugs and more precise in attacking tumor cells while sparing normal cells.

Visit the UCLA Brain Tumor Program website for more information.

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