Brain Tumor and Neuro-Oncology Center - Cleveland Clinic

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Clinical Programs (continued)
neuro-oncology patients, using image guidance. This
technology gives us the ability to treat lesions near
critical structures, such as the optic nerves and chiasm,
as well as re-treat some patients who have undergone
conventional radiotherapy. In general, Gamma Knife
is used for single treatments of focused radiation that
conforms to the shape of small tumors or lesions,
while Novalis delivers fractionated conformal treatment
for larger malignant or benign tumors. Although
Novalis was originally developed to treat brain tumors,
Cleveland Clinic physicians recognized its potential for
treating extracranial tumors, particularly primary and
metastatic spinal tumors that are difficult to treat due
to their proximity to critical structures. In 2007, we
became one of the busiest spine radiosurgery programs
in the nation to use the Novalis platform.
In addition to the Gamma Knife, Novalis System and
linear accelerators, we offer IORT with the INTRABEAM
device, a 50 kVp contact unit that is placed in the
resection cavity. We have an ongoing Phase II trial
evaluating the use of INTRABEAM for patients with a
single brain metastasis that has been resected.
A number of clinical trials sponsored through the
Radiation Therapy Oncology Group (RTOG), NABTT
and various pharmaceutical companies are offered
here. Since 1998, the department has been a leader
in radiation sensitizer trials using motexafin gadolinium
and efaproxiral. Dr. John Suh was the principal
investigator for the international Phase III confirmatory
study using efaproxiral for women with brain metastases
from breast cancer. Dr. Samuel Chao’s research interest
includes radiation necrosis, a potential complication of
radiation treatment, and treatment of pediatric brain
tumors. Both have given a number of national and
international talks regarding the treatment of brain
tumors with radiation therapy and radiosurgery.
BRAIN TUMOR AND NEURO-ONCOLOGY CENTER
Pediatric and Young Adult Brain Tumor Program
A multidisciplinary clinic for children and adolescents
with brain tumors takes place twice weekly. Patients
can see Drs. Tanya Tekautz and Bruce Cohen on the
same day, and other team members are consulted as
necessary. Sedation by a pediatric anesthesiologist for
neuro-imaging is routinely available on all clinic days.
Each child has a care coordination team consisting of a
physician, a nurse practitioner and a registered nurse.
Neurosurgeons and radiation oncologists are available to
see patients as needed. During 2008, there were a total
of 570 pediatric outpatient visits.
Chemotherapy and radiation therapy are delivered
under the oversight of the coordination team, resulting
in continuity of care. The nurse practitioner/RN team
handles follow-up calls at home to ensure the efficacy of
pain control and other medical issues, which results in
fewer emergency room visits.
Since 2004, total volume has more than doubled,
increasing by 138 percent.
Pediatric Outpatient Visits
600 ______________________________________________________
300 ______________________________________________________
0 ______________________________________________________
2004 2005 2006 2007 2008