Brain Tumor Program
The Neuroscience Institute's Brain Tumor Program is a unique collaboration between the medical center's Neuroscience and Cancer Institutes. The program provides comprehensive services to adults and children with primary brain tumors and metastatic lesions to the central nervous system, as well as complex spinal tumors. Each year, MMC treats hundreds of patients with brain and spinal tumors, including some of the most difficult cases in the state. This is a testament to the experience, expertise, and state-of-the-art technology available here. The program is led by Medical Director Devon Evans, M.D., an oncologist with particular expertise in the care of neuro-oncology patients.
A multidisciplinary team including medical oncology, neurosurgery, radiation oncology, neuroradiology, pathology, and palliative care work together to tailor treatment plans to the individual patient. These plans take into account the needs of each patient and family while providing high quality care close to home.
- Maine's most comprehensive, multidisciplinary team of specialists with expertise in tumors of the brain, spine and central nervous system, including the state’s only Board certified neuro-oncologist, Christine Lu-Emerson, M.D.
- Outstanding neurosurgical expertise that is unparalleled in the state
- A coordinated approach to care that also addresses the patient's and family's psychosocial needs
- A full complement of leading-edge diagnostic and treatment services for adults and children, many of which are not available any place else in Maine
- Access to novel therapies as part of MMC's ongoing participation in clinical trials
- Specialized and personalized support for patients and family provided by a neurosciences patient navigator
The Neuro-Oncology Program treats some of the most common and rare brain and spinal tumors in both adults and children, including:
- Anaplastic and low-grade astrocytomas
- Glioblastomas (GBM)/gliosarcomas
- Mixed malignant gliomas
- Primary CNS lymphomas
- Ewing's sarcoma
Diagnostic & Treatment Resources
With state-of-the-art technology, our multidisciplinary team has a wealth of diagnostic and treatment resources for patients with brain and spinal tumors:
- Advanced pre-surgical and intraoperative planning: Our neurosurgeons employ neuro-navigational technology that combines sophisticated imaging techniques and advanced computer software to visualize the brain in three dimensions and determine the precise location of a brain tumor - minimizing risk to surrounding areas of the brain and improving the extent of tumor removal.
- Stereotactic radio surgery: This procedure allows for precise targeting of brain tumors otherwise unable to be removed with standard operating techniques.
- Intensity modulated radiation therapy: This technique of radiation treatment allows for higher doses of radiation to the tumor while protecting the surrounding brain tissue.
- Awake craniotomy with language mapping: This technique can be used in certain cases when a tumor infiltrates brain tissue that affects an essential function such as speech. The patient is fully anesthetized during the opening and closing portions of surgery; after the brain is exposed, the patient is brought into a conscious state and relevant areas of the brain are stimulated to assess for function and pinpoint what tissue can be safely removed.
- Chemotherapy: A full range of traditional chemotherapeutic agents and targeted molecular therapies are available.
- Advanced imaging techniques, including MRI perfusion, functional MRI, diffusion weighted imaging, and spectroscopy
- Embolization: This approach is performed by an interventional neuroradiologist, reduces the blood supply to the cancer, often causing the tumor to shrink and making it easier to treat surgically or with radiation.
- Clinical Trials: MMC has the largest center for brain tumor research in Maine. Our team works closely with the MMC Research Institute, and we collaborate with Dana-Farber Cancer Institute and Jackson Laboratories. We have patients enrolling in clinical trials, also called research studies, of new treatments that may improve outcomes for them and teach us more about this cancer. Recent or current studies include:
- Newly diagnosed GBM: Phase II/III Randomized Trial of Veliparib or Placebo in Combination with Adjuvant Temozolomide in Newly Diagnosed Glioblastoma with MGMT promoter Hypermethylation
- Recurrent GBM: Randomized Phase II Trial of Concurrent bevacizumab and Re-Irradiation Versus bevacizumab Alone as Treatment for Recurrent Glioblastoma
- Anaplastic Glioma: Phase III Intergroup Study of Temozolomide alone vs. Radiotherapy and concomitant and adjuvant temozolomide vs. Radiotherapy and adjuvant PCV chemotherapy in patients with 1p/19q co-deleted anaplastic glioma
- CNS Lymphoma: Phase II Randmonized Trial to Rituximab, Methotrexate, Procarbazine, Vincristine and Cytarabine +/- Low Dose Whole Brain RT for Primary CNS lymphoma
- A Phase 3, Randomized, Open-Label Study to Evaluate the Efficacy and Safety of Eflornithine with Lomustine Compared to Lomustine Alone in Patients with Anaplastic Astrocytoma That Progress/Recur After Irradiation and Adjuvant Temozolomide Chemotherapy (STELLAR Study)
- A Phase II/III Randomized Trial of Veliparib or Placebo in Combination with Adjuvant Temozolomide in Newly Diagnosed Glioblastoma with MGMT Promoter Hypermethylation (Alliance A071102)
- Alliance A071101: A Phase II Randomized Trial Comparing the Efficacy of Heat Shock Protein-Peptide Complex-96 (HSPPC-96) Vaccine Given with Bevacizumab Versus Bevacizumab Alone in the Treatment of Surgically Resectable Recurrent Glioblastoma Multiforme (GBM)
- Longitudinal Assessment of Neurocognitive Function in Glioma Patients and Identification of Predictive Biomarkers
Quality Outcomes: Glioblastoma
Glioblastoma, also called GBM, is a type of malignant brain cancer. At MMC, patients with GBM receive care from a team of experts, including doctors who are highly trained in neuro-oncology, neuro-radiology, and neuro-surgery. The patients’ cases are the subject of “tumor boards,” meetings of the multidisciplinary team that includes a clinical nurse navigator. Below is a sampling of the data we track on the care of these patients, and patients with other brain tumors.
VOLUME OF PATIENTS
Cutting edge, compassionate, and high quality care of patients with brain tumors requires a level of expertise only found at institutions with high patient volumes. At the Brain Tumor Program at Maine Medical Center, we see and treat more patients with brain tumors than any other hospital in the state.
We discuss cases in tumor board to ensure the expertise of all of our specialists is included in a consensus treatment plan. This plan is then presented to the patient at our multidisciplinary clinic, a unique collaboration in the state of Maine.
The treatment of a brain tumor requires more than a team of dedicated and experienced physicians. At the Brain Tumor Program at Maine Medical Center, our patients are all assigned a Patient Navigator. The navigator ensures that the patient has access to a wide range of support services available at Maine Medical Center.
CLINICAL TRIAL ENROLLMENT
Clinical trials, also called research studies, have the potential to help patients through the cancer experience and improve their outcomes, as well as inform how we care for patients in the future.
TIME TO TREATMENT
Time from surgery to treatment is tracked to ensure that our patients with brain tumors are receiving post-operative chemotherapy and radiation in a timely fashion if required. Treatment given too soon or too long after a brain surgery is associated with inferior results.
LENGTH OF STAY
The Brain Tumor Program at Maine Medical Center closely monitors surgical outcomes, including data measuring length of stay following a procedure, and re-admission rates. These established metrics provide an indication of high quality surgical and post-operative care, including discharge planning.
30-DAY READMISSION RATE