Dear OncoLink "Ask The Experts,"
Our soon-to-be 29 year-old daughter has astrocytoma. One pathologist report said it was Stage 2; UCSF Med Center pathology report read it as having characteristics of Stage 3. Radiation/chemotherapy treatments were suggested. My question: Does the radiation have to be of the entire brain? Her tumor (what is left after 2 surgeries) is in a good location (part that affects left side movement). It is rather deep, though. Our doctors suggest entire brain. We are VERY concerned about radiation! We need some advice.
Robert Lustig MD FACR, Clinical Associate Professor, Department of Radiation Oncology, University of Pennsylvania, responds:
Without reviewing the records and examining your daughter, it is difficult to formulate a response. However, based on what you tell me, at our institution, the radiation would probably not be delivered to the whole brain. You mentioned receiving an opinion from UCSF. They have an excellent neuropathology department so we will assume they are correct and that it is a Grade 3 tumor. The best treatment is combined chemotherapy using Temodar and radiation. The radiation therapy should be directed to the tumor with a surrounding margin to treat any microscopic disease that may be outside the area seen on the MRI. While the radiation may have some long- term side effects, it is the best option for treating this tumor.