Treatment of brain tumors depends on the type of tumor, its size and location, as well as patient-related factors such as general condition, age, symptoms, other diseases, and medications. The decision on treatment is made in multidisciplinary conferences where different specialties are represented, including neuro oncologists, neurosurgeons, pathologists, and radiologists. Based on the information gained from the diagnostic procedures in combination with patient characteristics, a recommendation of treatment is made and discussed with the patient.
Surgery is an essential part of brain tumor treatment and aims to achieve maximal tumor resection, decompression, and histopathological diagnosis with maintained function of the patient. In cases of difficult tumor location, a biopsy can be an option for resection. The neurosurgery at our center is performed with integrated high-technology solutions, including fluorescence microscopy, neuro navigational equipment, intraoperative MRI, and endoscopic craniofacial surgery. Methods used to preserve neurological function include functional MRI, transcranial magnetic stimulation, intraoperative neurophysiological monitoring, and awake brain surgery. Our center was the first center in the Nordic countries to treat patients with laser interstitial thermal therapy (LITT), an emerging technique using lasers to treat brain tumors that can be hard to reach with conventional surgery. Gamma Knife, a high-precision stereotactic radiation therapy technique, was developed at our center and is now widely used worldwide to treat smaller tumors with high precision, preserving function in the surrounding brain and avoiding the risks of open surgery.
Radiation therapy is a treatment option either after surgery or as a primary treatment, depending on the type of tumor and the patient's conditions. Our center offers the different techniques for radiation therapy that may be required to individualize treatment, including external beam radiation using linear accelerators, proton therapy at our national proton therapy center located in Uppsala, and stereotactic radiosurgery using the Gamma Knife.
Medical treatments are given in combination with radiation therapy and/or surgery or alone as a single treatment. Chemotherapy is the most common form of medical treatment of brain tumors, with temozolomide, lomustine, and PCV (procarbazine, lomustine (CCNU), and vincristine) commonly used as chemotherapeutic agents. In some selected patients, targeted therapies may be used based on molecular analyses of the tumors. Tumor treating fields (TTFields), or Optune, is a new treatment modality used at our center. TTFields uses low-intensity, intermediate-frequency (200 kHz) alternating electric fields via transducer arrays applied to the scalp and has been shown to be of clinical benefit in selected glioblastoma patients.