Most patients undergo a series of radiation treatments starting about two weeks after surgery. Radiation therapy is an important part of the treatment of high-grade gliomas. A doctor who supervises radiation treatments is called a radiation oncologist.
Before you get started with treatments, you will have a radiation planning session called a simulation. Your daily set up for radiation treatment will be decided during this session. It should be a comfortable position for you, usually with you lying on your back. Either a CT scan or X-ray pictures are taken of your head to use for radiation planning. This is a special scan that is different from other scans that you may have had for diagnosis or seeing the details of your tumor.
Treatments are given daily, Monday through Friday for about 6 weeks. Each treatment takes only a few minutes and is painless. Patients are seen weekly by the radiation oncologist, and a nurse is available for questions every day.
An MRI will be performed about 2 to 4 weeks after the end of radiation therapy in order to assess the status of the tumor. Usually this scan will show no change from the MRI performed immediately following surgery, which is good. Some shrinkage is even better. Growth of the tumor during radiation therapy is a sign of a more aggressive tumor.
Most side effects will be mild and can be easily managed. The common side effects are:
- Hair loss in the area being treated by radiation. This can sometimes be permanent.
- Skin redness, dryness, or irritation in the areas exposed to radiation.
- Fatigue, usually starting the second or third week of treatment. For many, a nap is helpful every afternoon.
- Nausea does not occur for all patients but can be managed with medication if it occurs.
- Headaches do not occur often but should be mentioned to your doctor and can usually be managed with standard headache medications. Do not take aspirin or aspirin-containing medications. Tylenol is fine.