Brain tumours

diagnosis and treatment of brain tumours 

The Clinica Universidad de Navarra has extensive healthcare and research experience in the treatment of brain tumours. It is a pioneer in the techniques and clinical trials, such as immunotherapy for the treatment of glioblastoma and the use of fluorescence microscopy to achieve extraordinary rates of complete extirpation of malignant gliomas.
Research studies have shown that the survival and cure rate for brain tumours depends, in good measure, on the total extirpation of the tumour.
Glioblastoma multiforme is the most common type of malignant brain tumour. Its extirpation is complicated because its diffuse nature hinders its differentiation from healthy brain tissue.
The Clinica Universidad de Navarra has therefore included fluorescence microscopy for the performance of brain surgery, using a safe substance that can completely identify the tumour area and differentiate it from the healthy area, achieving total extirpation of the tumour in 83% of cases, compared with the 30% achieved in the past.

Imaging tests

The Clínica has the most advanced imaging tests. Magnetic resonance [SP] imaging helps us see brain tissue lesions, their location and size. By adding the most sophisticated resonance and PET sequencing with methionine, the type of tumour can be determined. This information can be transferred to navigation devices in the operating room that correlate these images with the actual space in which the surgeons will work.

Biopsy [SP] 

In order to establish an accurate diagnosis of the tumour type and grade, tissue needs to be taken and analysed by a neuropathologist. The biopsy can be performed through open surgery or by image-guided puncture. This latter technique is known as stereotactic surgery, which results in less discomfort for the patient. With a meticulous technique in the operating room and laboratory, it is possible to obtain a sample of sufficient quality and quantity for diagnosis and perform the necessary molecular marker tests.

Plasma analysis

This test detects the presence of the glioma and its grade of malignancy in cases in which, due to its location, it is impossible to perform a biopsy.

The use of fluorescent microscope gets double complete excisions of malignant brain tumors. [Video only available in Spanish]

For an immunotherapy treatment to be efficient, we use a fluorescent microscope in the operating theatre, which increases the percentage of tumorous tissue removed".

The Clinica Universidad de Navarra has fluorescence microscopy, a new technique that enables the total extirpation of the tumour in more than 80% of cases. 
The objectives of brain tumour surgery are the following:
  1. An accurate and precise diagnosis of the tumour. 
  2. A reduction in the pressure on the healthy brain to improve the symptoms.
  3. Total extirpation can heal the tumour and facilitate the effects of other treatments.
  4. Extirpation without damaging healthy neighbouring areas.

Neurophysiological monitoring in the operating room

This system helps determine whether the surgery can or cannot continue through an area without causing sequelae in the patient. Increases the extirpation and reduces the complications.
Intraoperative image-guided surgery
For all tumours, prior MRI is used as a map for a navigator that assists the surgeon.
The objective of chemotherapy is to destroy the tumour cells.
In the case of brain tumours, there are two important characteristics that make it more difficult to administer chemotherapy:
  • The blood-brain barrier, which protects the central nervous system from the arrival of toxic substances in the blood.
  • The special resistance of these tumours to current chemotherapy drugs.
The chemotherapy used will depend on the type of brain tumour. Chemotherapy has been shown to be effective in extending survival for patients with high-grade gliomas.
Chemotherapy is the treatment of choice for most patients with primary lymphomas of the central nervous system, after the biopsy confirmation of the diagnosis.
For brain tumours that occur in children, chemotherapy is essential because these tumours have greater sensitivity to such drugs.
Despite all of the treatments, in many cases chemotherapy does not manage to stop the progression of the disease. It is therefore important to continue basic research and clinical trials.

Radiation therapy can cure some benign tumours.

Proper planning and execution of radiation therapy is essential for ensuring that the tumour is applied the maximum dose while at same time preserving and not damaging normal tissue.

In the Clínica, this level of precision is possible because we have qualified and highly experienced professionals and the most advanced technology in imaging tests for correct and careful planning.

Radiation therapy can also cure some benign tumours, especially if their size and location allow for sufficiently high radiation to be administered to the tumour.

Studies have shown that its administration in the postoperative period does not increase the survival of these patients, but it does increase the time during which the tumour is controlled.

Tailored cellular vaccines against the most aggressive brain tumours
The Clínica is the only centre in Spain that has conducted a study for the treatment of glioblastomas with immunotherapy. The new therapy, which is administered to participating patients in the form of vaccines, is combined with standard first-line treatment. It consists of surgical extirpation of the tumour, followed by the administration of radiation therapy and chemotherapy with temozolomide.
The immune system is essential in the development and management of tumours. The objective of immunotherapy is to repair or increase the patient’s immune system response.
Limited disease and the combination of immunotherapy and chemotherapy make this a good added option to the treatment of patients with glioblastoma.

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