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Brain tumour radiotherapy

Radiotherapy uses high energy waves (X-rays) to treat cancer. It is a common treatment for brain tumours. Radiotherapy may be your main treatment if you have a brain tumour that your surgeon cannot remove. Or you may have radiotherapy after surgery to treat any remaining tumour cells or to lower the risk of the tumour coming back in the future.

You have treatment in the hospital radiotherapy department, usually as an outpatient. You have to travel to the hospital every day during your radiotherapy course. If you live a long way away, you may be able to stay in the hospital in a hostel type room. Having external radiotherapy does not make you radioactive. It is perfectly safe to be with other people, including children, throughout your treatment course.

Masks and planning

You have 2 or 3 outpatient appointments before you start radiotherapy. The first is usually to make a mask of your face to keep you very still during the treatment. The further appointments are so that the radiotherapy doctor (neuro oncologist) can carefully plan your treatment. You lie under a CT scanner which takes images of the area to be treated and may have an injection of dye (contrast) into a vein to show up the area more clearly. 

Your treatment team feed into the computer the CT scan and any MRI scans of your tumour. They use this information to work out the dose and shape of the radiotherapy treatment field. They aim to give a high radiotherapy dose to the cancer cells and keep the dose to the normal brain tissue as low as possible. 

Having brain tumour radiotherapy

You are most likely to have the radiotherapy as a series of treatments from Monday to Friday, for 5 to 7 weeks. If you are having a shorter course of radiotherapy to help with symptoms or slow down the growth of your tumour, you usually have treatment for about 2 weeks. To have treatment you lie on the treatment table. The radiographer fits your mask and attaches it to the table. Each treatment takes a few minutes.

The radiographers will help to position you on the couch and make sure that you are comfortable. They need to leave the room for the minute or two the machine is switched on. But they can hear you through an intercom and see you on a TV screen, so you can call if you need them. The radiotherapy machine may move around you to give treatment from different angles.

 

CR PDF Icon You can view and print the quick guides for all the pages in the Treating brain tumours section.

 

 

What radiotherapy is

Radiotherapy uses high energy waves (X-rays) to treat cancer. It is a common treatment for brain tumours. Radiotherapy may be your main treatment if you have a brain tumour that your surgeon cannot remove. Or you may have radiotherapy after surgery either

  • To treat any tumour that your surgeon couldn't remove
  • To try to lower the risk of the brain tumour coming back in the future
 

The radiotherapy department

You have radiotherapy treatment in the hospital radiotherapy department. You usually have the treatment as an outpatient, so you have to travel to the hospital each week day throughout your course of radiotherapy. If you live a long way from the hospital you may be able to stay in the hospital in a hostel type room.

 

How you have brain tumour radiotherapy

You are most likely to have radiotherapy for a brain tumour as a series of treatments for 5 to 7 weeks. You usually have one treatment a day, from Monday to Friday. For some types of tumour you may have treatment twice a day. 

If you are having a shorter course of palliative radiotherapy to help with symptoms or slow down the growth of your tumour, you usually have treatment for about 2 weeks.

Many hospitals have radiotherapy machines that give very precisely targeted treatment called stereotactic radiotherapy. This treatment gives high doses of radiotherapy to the area of the tumour and can treat some small tumours in certain areas of the brain. We have information about stereotactic radiotherapy and radiosurgery for brain tumours in this section. 

You will have 2 or 3 outpatient appointments before you start radiotherapy. The first is usually to make a mask of your face to use during the treatment. The further appointments are so that the radiotherapy doctor (neuro oncologist) can carefully plan your treatment.

 

The treatment mask

Before you start your treatment you go to the hospital mould room to have a plastic mask made. The mask is sometimes called a shell or mould. It covers the whole of your face and the front of your head. The mask keeps your head completely still while you are being treated. You can see through it. Any marks that the radiographers need to line up the radiotherapy machine can be made on the mask instead of on your skin.

Here is a picture of a treatment mask.

Photograph of a radiotherapy mask

Many radiotherapy departments use a type of plastic mesh called thermoplastic to make the masks. This is a sheet of plastic that is soft when warm but it hardens as it cools. The warmed plastic is draped over your face and shaped to your face and head. It has holes in the mesh so you can breathe easily. When the plastic cools it gives an exact impression of your face and head. This takes from 20 to 30 minutes.

The video below shows you what is like to have a mesh mask made.

You need to visit the mould room again to make the plastic legs that attach the mask to the radiotherapy treatment table. The radiographer may draw marks on your mask during the planning session. The marks help the radiographers to line up the radiotherapy machine very precisely when you have your treatment.

You only have to wear the mask when you go for treatment. Once you are lying down the radiotherapy staff put the mask over your head and fix it to the radiotherapy treatment table on either side. This stops you from moving during the treatment.

 

Planning your treatment

Specialists plan radiotherapy very carefully. At your first visit you lie under a CT scanner which takes images of the area to be treated. You may have an injection of dye (contrast) into a vein to help the doctor see this area more clearly. The photo shows someone having a planning CT scan.

Photograph of someone having a planning CT scan before radiotherapy for a brain tumour

After the scan you can go home. Your treatment team use the CT scan and also feed into the computer any MRI scans of your tumour. They use this information to work out

  • The exact shape of the tumour
  • Where important structures are in relation to the tumour (for example, your eyes)
  • The direction to aim the radiation beams so that they avoid all the important structures

Using the scans the treatment team works out where to give your treatment. They aim to give a high radiotherapy dose to the cancer cells and keep the dose to the normal brain tissue as low as possible. They may use radiotherapy beams from a number of different angles. The highest dose is given where all the beams cross.

 

Having brain tumour radiotherapy

Below is a 360° photograph of a radiotherapy room containing a linear accelerator (LINAC) radiotherapy machine. If you can't see the photograph, you can download the Adobe Flash Player from the Adobe website. You can use the arrows to move the picture and look around the room.

 

To have treatment you lie on the treatment table. The radiographer fits your mask and attaches it to the table. Each treatment only takes a few minutes. Exactly how long depends on the number of directions from which you will be treated. 

The linear accelerator beam can be moved around. In the photo, the beam would come from the top. But the machine can swing round in an arc. So you may have the treatment from a number of different directions during each treatment session. Some treatments use a machine that moves around your head and gives the radiotherapy in a series of arcs.

The radiographers will help to position you on the couch and make sure that you are comfortable. They need to leave the room for the minute or two the machine is switched on. But the staff will be able to hear you through an intercom and see you on a TV screen, so you can call if you need them. 

There may be a small delay while the radiographers take pictures of the tumour and compare them to your planning CT scan. The couch may then move as they adjust your position. They then turn on the machine to give the treatment and it may make a buzzing sound. It doesn't hurt. You will not be able to feel it at all. But you must lie very still for the few minutes it takes to treat you.

This video below shows how you have radiotherapy for a brain tumour or a head and neck cancer:

View a transcript of the video showing radiotherapy for a brain tumour or a head and neck cancer (opens in new window).

 

Radiotherapy and other people

Having external radiotherapy does not make you radioactive. It is perfectly safe to be with other people, including children, throughout your treatment course.

 

More about radiotherapy

In this section we have pages about stereotactic radiotherapy for brain tumours and radiosurgery for brain tumours. We also have information about the side effects of brain tumour radiotherapy

You can also look at the general radiotherapy section. It tells you more about this type of treatment including

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Updated: 27 December 2013