Radiation oncologist Josh Yamada is an expert in image-guided radiation therapy and other forms of treatment for people with glioma.
Radiation therapy can shrink or kill tumor cells. At Memorial Sloan Kettering, we treat glioma tumors with state-of-the-art radiation therapy tools, such as linear accelerators and advanced imaging techniques.
Radiation can be directed precisely to the tumor, sparing the nearby healthy tissue and leading to better outcomes. We can verify within millimeters that the setup for each MSK patient is accurate and can be reproduced from treatment to treatment.
We may recommend radiation therapy as your first treatment, combined with surgery, chemotherapy, or both. We may also recommend it for tumors that come back after initial treatment.
We use two main types of radiation therapy for gliomas. Which is the best for you depends on the type, size, and location of the tumor.
Intensity-Modulated Radiation Therapy
Intensity-modulated radiation therapy (IMRT) uses sophisticated software and 3-D images from CT scans to focus radiation directly on a tumor. These pencil-thin beams vary in intensity and conform to the specific shape and size of the tumor. This highly focused approach reduces radiation exposure to healthy tissue in the brain. IMRT can also decrease the chance of side effects.
Image-Guided Radiation Therapy
Image-guided radiation therapy (IGRT) uses real-time imaging with CT scans or X-rays during radiation therapy to help ensure ideal positioning and stillness during treatment. IGRT delivers radiation with great accuracy.
MSK care teams may recommend stereotactic radiosurgery to treat a glioma with one high dose of radiation. This technique uses advanced imaging technologies combined with sophisticated computer guidance to deliver a highly targeted and intense dose.
Radiation for Glioblastoma
Radiation therapy for glioblastomas typically occurs following surgery. Studies have shown that people live longer when given the combination of surgery and radiation therapy compared with surgery alone. Radiation also may be used as the sole treatment when a glioblastoma tumor is in an area that is not appropriate for surgery.
Radiation is usually given along with a chemotherapy drug called temozolomide (Temodar®). The drug makes the tumor more sensitive to the radiation. Studies have shown that this combination is more effective than radiation without temozolomide.
The most common schedule of radiation therapy for a glioblastoma is six weeks of daily treatment with a low dose of radiation. This amount of radiation is well tolerated by most people. It causes few side effects.
Sometimes we recommend proton therapy, a type of radiation that uses charged particles called protons instead of the X-rays that are used in conventional radiation therapy. This is most frequently used for glioblastoma tumors that are deep in the brain. It is occasionally used after a tumor has come back after previous treatment. In 2019, Memorial Sloan Kettering began delivering proton therapy at the New York Proton Center, a state-of-the-art facility in upper Manhattan.
Radiation Safety
Keeping you as safe as possible during radiation therapy is as important to your MSK care team as the treatment itself. Our medical physicists work closely with radiation oncologists to carefully plan radiation dosages before treatment. Medical physicists are also there during treatment to ensure that the radiation is delivered correctly and in the best possible places.
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