Tumors brain, localization

Tumor (brain) Headaches, visual disturbances, localized physical weakness... 

Weiss SR, Raskind R. Treatment of malignauit brain tumors by local methotrexate. A preliminary report. Int Surg 1969 51 149-155. 

Radiation is an important modality in the treatment of symptomatic metastatic disease. The most common indication for treatment with radiation therapy is painful bone metastases or other localized sites of disease refractory to systemic therapy. Radiation therapy gives significant pain relief to approximately 90% of patients who are treated for painful bone metastases. Radiation is also an important modality in the palliative treatment of metastatic brain lesions and spinal cord lesions, which respond poorly to systemic therapy, as well as eye or orbit lesions and other sites where significant accumulation of tumor cells occurs. Skin and/or lymph node metastases confined to the chest wall area also may be treated with radiation therapy for palliation (e.g., open wounds or painful lesions). 

BNCT sensitisers are designed with neutron capture in mind, but those that are porphyrin/ phthalocyanine-based may show PDT activity. An example is the disodium (or dipotassium) salt of the tetrakis-carborane ester (58) derived from 3,8-bis(l,2-dihydroxyethyl)deuteroporphyrin.298 This is water soluble and tumor selective, showing high tumor/normal brain ratios.299 Photophysical properties are similar to other water-soluble porphyrins in rat glioma cells, specific localization in mitochondria is observed.300... 

Early clinical studies clearly demonstrated that cisplatin could be administered safely and concurrently with radiation therapy (73-75). Early clinical trials that demonstrated the promise of the combination of cisplatin and radiation therapy included the treatment of brain tumors (76,77), head and neck tumors (78), malignant melanoma (79), and bladder cancer (80). Early clinical trial integrating carboplatin administration with radiation therapy was carried out in patients with locally advanced nonsmall cell lung cancer (NSCLC) (81). A hypothesis put forth by Coughlin and colleagues (81) was that the best clinical outcomes would be achieved with the combination of cisplatin and radiation therapy in tumors that were responsive to cisplatin. 

Concurrent therapy for the treatment of more than three brain metastases using paclitaxel and radiation has been explored in a phase III trial (144). The hypothesis here being that high-dose paclitaxel in combination with cranial radiation should improve local control while providing systemically active amounts of chemotherapy. Unfortunately, there was no statically significant improvement in survival seen. There is certainly a place to further explore the benefits and toxicides experienced with concurrent taxane-based therapy with radiation in metastatic disease. The role of the taxanes in concurrent chemoradiotherapy with sarcomas and pediatric tumors has not been explored at this time. 

MRI is the diagnostic modality of choice. Tumor localization as well as alterations of the blood brain barrier can be characterized for most tumors. However, the differentiation of tumor tissue and cerebral edema is difficult. 

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