Decrease (-) Restore Default Increase (+)
Bookmark and Share

Related Information

Brain tumors - primary


Primary Brain Tumors

Primary brain tumors are tumors that start in the brain. There are many types and subtypes of primary brain tumors; some are benign, others malignant. Examples include:

  • Gliomas
  • Meningomas
  • Medulloblastomas
  • Pituitary adenomas
  • Central nervous system lymphomas



Risk Factors




  • Type of tumor
  • Tumor grade
  • Person's age
  • Person's ability to function
  • How far the tumor has spread











They can be benign (noncancerous, meaning that they do not spread elsewhere or invade surrounding tissue) or malignant (cancerous). Cancerous (malignant) brain tumors are classified as either primary or secondary tumors. Primary tumors start in the brain. Secondary tumors spread to the brain from another site such as the breast or lung. This report focuses on primary malignant brain tumors.

Primary Brain Tumors

Primary brain tumors can be either benign (non-cancerous) or malignant (cancerous).

Benign Brain Tumors: Benign tumors represent half of all primary brain tumors. Their cells look relatively normal, grow slowly, and do not spread (metastasize) to other sites in the body or invade brain tissue. Benign tumors can still be serious if they are in vital areas in the brain. They can be life-threatening if they exert pressure on sensitive nerve tissue or if they increase pressure within the brain. Fortunately, most benign brain tumors can be successfully treated.


Malignant Brain Tumors: A primary malignant brain tumor is cancer that originates in the brain itself. Although primary brain tumors often transmit cancerous cells to other sites in the central nervous system (the brain or spine), they rarely spread to other parts of the body.

Brain tumors are generally named and classified according to either:

  • The type of brain cells from which they originate
  • The location in which the cancer develops

The biologic diversity of these tumors can make classification difficult.

Secondary (Metastatic) Malignant Brain Tumors

A secondary brain tumor is metastatic cancer. Secondary brain tumors occur when cancer cells spread (metastasize) to the brain from a primary cancer in another part of the body. Most often, cancers that spread to the brain originate in the lung, breast, kidney, or skin. Secondary tumors are about three times more common than primary tumors of the brain.

All secondary (metastatic) brain tumors are malignant (cancerous). This report discusses primary malignant brain tumors.

Primary Glioma Brain Tumors



  • Grades I and II tumors are the slowest-growing and least malignant; grade I tumors are generally considered borderline between benign and malignant.
  • Grade III tumors are considered malignant and grow at a moderate rate.

Gliomas may develop from several types of glial cells.


  • Grade III. Anaplastic astrocytoma typically occurs in adults ages 30 to 60 and is more common among men than women.
  • Grade IV. Glioblastoma multiforme(GBM), also called glioblastoma, accounts for about 50% of all astrocytomas and is one of the deadliest types of brain tumors. These highly malignant aggressive tumors grow rapidly. They are most common in older adults (ages 50 to 70), particularly men. Only about 10% of childhood brain tumors are glioblastomas.

Oligodendrogliomas: develop from oligodendrocyte glial cells, which form the protective coatings around nerve cells. Oligodendrogliomas are classified as either low-grade (grade II) or anaplastic (grade III). Pure oligodendrogliomas are rare. In most cases they occur in mixed gliomas. Oligodendrogliomas usually occur in younger and middle-aged adults.


Mixed gliomas: contain a mixture of malignant gliomas. About half of these tumors contain cancerous oligodendrocytes and astrocytes.


Location of the tumor: Gliomas are also described by the location of the tumor. Examples include:

  • Brain stem gliomas develop in the lowest portion of the brain. The brain stem connects the cerebrum (the largest part of the brain) to the spinal cord. Between 10 to 20% of brain tumors in children are brain stem gliomas. Most of these tumors are astrocytomas.

Click on the icon to see an image about brainstem function.

Click on the icon to see an image of the cerebellum.

. Click on the icon to see an image of the optic nerve.

Primary Non-Glioma Brain Tumors

Malignant types of non-glioma brain tumors include:

  • Medulloblastomas: are always located in the cerebellum, which is at the base and toward the back of the brain. These fast-growing high-grade tumors represent about 15 to 20% of pediatric brain tumors and 20% of adult brain tumors.
  • Pituitary tumors (also called pituitary adenomas): comprise about 10% of primary brain tumors and are often benign, slow-growing masses in the pituitary gland. They are more common in women than men.

  • Central nervous system (CNS) lymphomas: can affect both people with healthy immune systems and those who are immunocompromised due to other medical conditions (recipients of organ transplants, people infected with HIV). CNS lymphomas occur most often in the cerebral hemisphere but can also develop in cerebrospinal fluid, eyes, and spinal cord.

Benign types of non-glioma brain tumors include:

  • Meningiomas: are usually benign tumors that develop in the membranes that cover the brain and spinal cord (the meninges).




Only 5 to 10% of primary brain tumors are associated with genetic disorders. These inherited conditions and associated genes include:

  • Turcot syndrome (APC gene)
  • Tuberous sclerosis (TSC1 and TSC2 genes)
  • Li-Fraumeni syndrome (TP53 gene)



Risk Factors





Most brain tumors in adults occur between the ages of 65 to 79. Brain tumors also tend to occur in children younger than age 8. In children, malignant brain tumors are the leading cause of death from solid tumors (non-blood cell cancers).


The risk for primary brain tumors, especially gliomas, is higher in whites than in people of other races.

Environmental or Occupational Risk Factors

Exposure to ionizing radiation, usually from radiation therapy, is the only environmental risk factor that has been definitively linked to brain tumors. People who receive radiation therapy to the head during cancer treatment have an increased risk of developing brain tumors 10 to 15 years later. Workers in the nuclear industry are also at increased risk.

Despite much research, there is no evidence that electromagnetic field exposure from power lines or household appliances poses any risk. Several epidemiological studies have examined the cancer risk of wireless devices such as cell phones, which emit radiofrequency (RF) energy. To date, studies do not show an association between cell phone use and common brain tumors like gliomas and meningiomas. However, more research is needed to examine potential long-term effects, particularly for children and adolescents.


Medical Conditions



Advances in surgical and radiation treatments have significantly extended survival for people with brain tumors. These new treatments can often help reduce the size and progression of malignant gliomas.

Survival Rates


  • Tumor grade
  • Person's age
  • Person's ability to function
  • How far the tumor has spread

Some types of tumors have relatively good survival rates. Five-year survival rates for people with ependymoma and oligodendroglioma are, respectively, up to 91% and 85% for people ages 20 to 44, and 84% and 64% for people ages 55 to 64. For children, the survival rate for these brain tumors are about 75% and 95%.

Glioblastoma multiforme has the worst prognosis with 5-year survival rates of only about 17% for people ages 20 to 44 and 4% for people age 55 to 64. The 5-year survival rate for children is about 20%. Survival rates tend to be highest for younger people and decrease with age.

Grading Tumors


Grading is based on the appearance of the tumor cells as seen under a microscope:

  • Lower-grade (I and II) tumor cells are well-defined and almost normal looking. Some primary low-grade brain tumors are curable by surgery alone, and some are curable by surgery and radiotherapy. Low-grade tumors tend to have the most favorable survival rates, and high-grade the poorest outlook. However, this is not always the case. For example, some low-grade II gliomas are at very high risk for progression.
  • Higher-grade (III and IV) tumor cells are abnormal appearing and are more diffuse, which indicates more aggressive behavior. High-grade brain tumors usually require surgery, radiotherapy, chemotherapy, and possibly investigational treatments.



Brain tumors can produce a variety of symptoms, ranging from headache to seizure. They are great mimics of other neurologic disorders. Symptoms occur if the tumor directly damages the nerves in the brain or central nervous system, or if its growth puts pressure on the brain. Symptoms may be subtle and gradually become worse, or they may occur very rapidly.


Headache is probably the most frequent symptom of a brain tumor. However, headaches (especially tension-type and migraine) are very common, and the great majority of headaches are not caused by brain tumors. Most headaches associated with brain tumors are accompanied by other neurological symptoms.

Headaches caused by brain tumors vary depending on the tumor's location and other factors. Such headaches may have similar symptoms to other less serious types of headaches such as migraine, tension headache, or others.

Symptoms that may be associated with brain tumors include a headache that is:

  • Steady and worse upon waking in the morning, then goes away within a few hours
  • Persistent during sleep and accompanied by at least one other symptom (such as vomiting or confusion)
  • Accompanied by double vision, weakness, or numbness
  • Worse with coughing or exercise or with a change in body position

Gastrointestinal Symptoms

Gastrointestinal symptoms, including nausea and vomiting, are common.


About half of people with brain tumors have a seizure. It is a common symptom of brain tumors in older adults. A seizure may be the first symptom of a brain tumor in up to half of affected people.

Brain tumors may cause partial or generalized seizures:

  • Partial seizures are caused by localized tumors that affect one area of the brain. In this case, a person does not lose consciousness but may have confusion, jerking movements, tingling, or odd mental and emotional events.
  • Generalized seizures, cause loss of consciousness and are often associated with jerking movements of the whole body. In people with brain tumors, most generalized seizures start off in a specific area of the brain and then spread to involve the whole brain (partial seizures with secondary generalization).

Mental Changes


  • Memory loss
  • Impaired concentration
  • Problems with reasoning
  • Changes in personality and behavior
  • Increased sleep

Other Significant Symptoms

Other symptoms may include:

  • Gradual loss of movement or sensation in an arm or leg
  • Unsteadiness and problems with balance
  • Blurred or double vision
  • Hearing loss with or without dizziness
  • Difficulty speaking and understanding words


A neurological exam is usually the first test given when a person complains of symptoms that suggest a brain tumor. The exam includes checking eye movements, hearing, sensation, muscle strength, sense of smell, and balance and coordination. The doctor will also test mental state and memory.

Imaging Techniques

Advanced imaging techniques are an essential part of the diagnosis of brain tumors.

Magnetic resonance imaging (MRI): Magnetic resonance imaging (MRI) is the standard imaging procedure for diagnosing a brain tumor. It provides pictures from various angles that can help doctors to construct a three-dimensional image of the tumor. It gives a clear picture of tumors near bones, smaller tumors, brain stem tumors, and low-grade tumors. MRI is also useful during surgery to show tumor bulk, for accurately mapping the brain, and for detecting response to therapy.

MRI of the brain


Computed tomography (CT): uses a sophisticated x-ray machine and a computer to create a detailed picture of the body's tissues and structures. It is not as sensitive as an MRI in detecting small tumors, brain stem tumors, and low-grade tumors. It is useful in certain situations, however. Injection with a contrast material can make it easier to see abnormal tissues.

A CT scan helps locate the tumor and can sometimes help determine its type. It can also help detect swelling, bleeding, and associated conditions. CT is also used to evaluate the effectiveness of treatments and monitor for tumor recurrence.




Other advanced or investigational imaging techniques include:

  • Magnetic resonance angiography (MRA) evaluates blood flow. MRA may be used to plan surgical removal of a tumor suspected of having a large blood supply.

Lumbar Puncture (Spinal Tap)





In some cases, such as with brain stem gliomas, a standard biopsy might be too hazardous because removing any healthy tissue from this area can affect vital functions. In these cases, surgeons can use alternative techniques such as needle biopsy and stereotactic biopsy. Stereotactic biopsy is a computer-directed type of needle biopsy that uses images provided from MRI or CT scans to provide precise information on the tumor's location.

Wada Test

The Wada test is sometimes done before surgery. Medicine is given through a catheter and into each side of the brain, one side at a time. The person is asked to talk and perform other functions while each side of the brain is under the effect of the medicine. This enables the doctors to know if surgery for the tumor might affect certain brain functions.


Treatment of brain tumors can involve surgery, radiation therapy, and chemotherapy. Brain tumors are best treated by a team that includes:

  • Neuro-oncologist
  • Neurosurgeon
  • Medical oncologist
  • Radiation oncologist
  • Neurologist
  • Other health care providers, such physical therapists, and social workers

Standard Treatments


The intensity, combination, and sequence of treatments depend on:

  • The brain tumor type (there are over 100 types of brain tumors)
  • Its size and location
  • The person's age, health status, and medical history.


With some very slow-growing cancers, such as those that occur in the midbrain or optic nerve pathway, the person may be closely observed and not treated until the tumor shows signs of growth.

Other Treatments

TTF Therapy: Tumor Treating Fields (TTF) therapy uses a low-intensity electrical field to disrupt the rapid division of cancer cells. In 2011, the FDA approved the NovoTTF-100A System to treat adults with glioblastoma multiforme that has recurred or progressed despite chemotherapy and radiation. This device uses electrodes placed on the person's scalp to deliver alternating electrical fields to the tumor site. The device is portable and can be used at home.

Investigational Treatments: People with brain tumors can enroll in clinical trials that are researching new treatments.


Surgery is usually the first step in treating most brain tumors. In some cases, such as most brain stem gliomas and other tumors located deep inside the brain, it may be too dangerous to perform surgery.

The objective of most brain tumor surgeries is to remove or reduce as much of the tumor's bulk as possible. Reducing the tumor's size can help make other treatments, particularly radiotherapy, more effective.


The standard surgical procedure is called craniotomy.

  • The tumor is located and then removed.
Craniotomy - series


In stereotactic craniotomy, imaging techniques, such as CT and MRI scans, are used along with surgery to help map the area of the tumor in the brain.


Shunt Placement

Sometimes a brain tumor can create blockage and cerebrospinal fluid accumulates excessively in the skull, causing increased intracranial pressure. In these cases, a surgeon may implant a ventriculoperitoneal (VP) shunt to help drain the fluid.


Risks and Complications of Surgery

The most serious concern of brain surgery is preserving brain function. Neurosurgeons will try to be conservative in their approach so as to limit removing tissue that may cause a loss of function. Bleeding and blood clots are other complications.





Radiotherapy after Surgery: When it appears that the entire tumor has been surgically removed microscopic cancer cells often remain in the surrounding brain tissue. Radiation targets the residual tumor with the goal of reducing its size or stopping its progression. If the entire tumor cannot be removed safely, postoperative radiotherapy is often recommended. Even some benign gliomas may need radiation, since they may become life threatening if their growth is not controlled.

Radiotherapy When Surgery is not Appropriate: Radiotherapy may be used instead of surgery for inaccessible tumors or for tumors that have properties that are particularly responsive to radiotherapy.

Radiotherapy and Chemotherapy (Radiochemotherapy): Combining chemotherapy with radiotherapy is beneficial for some people with high-grade tumors.

Conventional Radiotherapy

Conventional radiotherapy uses external beams aimed directly at the tumor and is usually recommended for large or infiltrating tumors. It begins about a week after surgery and continues on an outpatient basis about 5 days per week for 6 weeks. Older adults tend to have a more limited response to external-beam radiation therapy than younger people.

Conventional external-beam radiation techniques include:

  • Three-dimensional conformal radiation therapy (3D-CRT) uses computer-generated imaging scans to map the tumor's location. Radiation beams are then used that conform to the three-dimensional shape of the tumor.
  • Conformal proton beam radiation therapy is also similar to 3D-CRT but uses proton beams instead of x-ray energy.

Stereotactic Radiosurgery

Stereotactic radiosurgery, also called stereotactic radiotherapy or stereotaxy, is an alternative to conventional radiotherapy that allows highly targeted radiation to be delivered directly to small tumors while avoiding healthy brain tissue. Stereotactic radiosurgery is radiation therapy, not surgery. The term radiosurgery is used because the destruction is so precise that it acts almost like a surgical knife.

Benefits of stereotactic radiosurgery include:

  • Stereotaxy allows precisely focused beams to be delivered with less damage to surrounding tissues. Because the beams are so focused and localized, stereotaxy can deliver higher x-ray doses than conventional radiotherapy.
  • Stereotactic radiosurgery can help reach small gliomas or other tumors in the brain or spinal cord that cannot be surgically removed.
  • The radiation is usually delivered in a single session, but it can be repeated if necessary. Stereotactic radiosurgery can also be used as a "booster" after conventional radiation therapy.
  • Combining stereotaxy with techniques that evaluate speech and other mental functions in people who are awake during the procedure can allow removal of brain tissue with a lower risk for complications in areas that affect such functioning.


  • First, a local anesthetic is given. In the standard operation, the person's head is immobilized by screwing a device known as a stereotactic frame into the skull. "Frameless" stereotaxy uses a mesh face mask. The frame or mask is removed when the procedure is completed.

Once the preliminary planning stage has been completed, treatment begins. Advanced machines, such as gamma knife and adapted linear accelerator (LINAC), are used with stereotaxy to deliver very focused beams of radiation. Actual treatment takes about 15 minutes to 2 hours:

  • Gamma knife uses gamma rays that are sent from multiple points to converge at a single point on the tumor. Although each gamma-ray beam is a very low dosage, when the beams converge, the intensity and destructive power is very high. The gamma knife is used only on very small tumors. It is generally used as a booster after standard radiation, surgery, chemotherapy, or combinations.
  • Linear accelerator (LINAC) produces protons (positively-charged atomic particles) in patterns that are matched to the tumor shape. The person is positioned on a bed that can be moved to allow flexible positioning. It allows treatment over multiple sessions of small doses (fractionated stereotactic radiotherapy), instead of a single session. This means that larger tumors can be treated.

Drugs Used With Radiation


  • Radioprotectors: Drugs such as amifosistine (Ethyol, generic) may protect healthy cells during radiation.

Side Effects of Radiation

Common Side Effects: Side effects of radiotherapy vary depending on the tumor type and radiation treatment. Side effects can include:

  • Hair loss
  • Fatigue
  • Headaches
  • Nausea and vomiting

Skin irritation and sensitivity may develop in the areas being treated. Brain swelling (edema) is another common radiotherapy side effect, which can sometimes cause an increase in neurologic symptoms. Edema can be treated with steroids.

Tissue Injury: Radiation necrosis (total destruction of nearby healthy tissue) occurs in some people treated with intensive radiation. Radiation necrosis can cause brain swelling and reduction in mental functions. The condition is treated with steroids. If steroids prove ineffective, surgery may be required to remove the damaged tissue.

New Tumors: Radiation therapy for childhood cancer is the most important risk factor for developing new brain and spinal column tumors. The risk appears greatest for children who received radiation therapy before age 5. The risk of second primary tumors increases in relation to the radiation dose used to treat the first cancer.



Chemotherapy uses drugs to kill or alter cancer cells. Chemotherapy is not an effective initial treatment for low-grade brain tumors. This is mostly because many drugs have a hard time passing into the brain due to the blood-brain barrier that protects the brain from harmful chemicals. In addition, not all types of brain tumors respond to chemotherapy. In general, chemotherapy for brain tumors is usually administered following surgery or radiation therapy.

The type of drug determines how it is administered:

  • Local delivery drugs are placed within or around the brain tumor.

Newer delivery methods to overcome some of these problems include:

  • Intrathecal chemotherapy delivers chemotherapeutic drugs directly into the spinal fluid.

Chemotherapy Drugs and Regimens


Temozolomide (Temodar, generic): Temozolomide is used for adults with anaplastic astrocytoma that did not respond to other treatments. It is used during and after radiation therapy for people newly diagnosed with glioblastoma multiforme.

The current first-line treatment for people with glioblastoma is combined radiotherapy and temozolomide, followed by monthly doses of temozolomide after radiation treatment ends. The drug may work best for people with a specific genotype.



If carmustine is administered intravenously, side effects may include:

  • Nausea and vomiting
  • Fatigue
  • Respiratory problems
  • Lung scarring (pulmonary fibrosis)



PCV Drug Regimen: PCV is an abbreviation for a chemotherapy regimen that combines procarbazine (Matulane), lomustine (Ceenu, CCNU), and vincristine (Oncovin, generic). PCV is commonly used to treat oligodendrogliomas and mixed oligoastrocytomas. The regimen has shown good results following radiation in treating people with low-grade gliomas. The drugs may be used alone or in other combinations.


  • Beer
  • Red wine
  • Aged cheeses
  • Processed or pickled meats
  • Soybean products


Other Chemotherapy Drugs: Researchers are investigating whether drugs used to treat other types of cancer may have benefits for brain tumors.

Biologic Drugs (Targeted Therapy)

Traditional chemotherapy drugs can be effective, but they can cause severe side effects because they do not distinguish between healthy and cancerous cells. Targeted biologic therapies work on a molecular level by blocking specific mechanisms associated with cancer cell growth and division.

Because they selectively target cancerous cells, biologic drugs may cause less severe side effects. In addition, these drugs hold the promise of creating options for more individualized cancer treatment based on a person's genotype.

Bevacizumab (Avastin): Bevacizumab (Avastin) is a biologic drug that blocks the growth of blood vessels that feed tumors (a process called angiogenesis). It is approved for the treatment of glioblastoma in people whose brain cancer has continued to progress after prior treatment with chemotherapy and radiation. Bevacizumab was the first targeted therapy approved for brain tumors, and the first new treatment for glioblastoma in more than a decade. Some recent studies have questioned its effectiveness.

Investigational Targeted Therapies: Many different targeted therapies are being tested in clinical trials. They include:

  • MTOR inhibitors are commonly used to suppress the immune system to prevent rejection after organ transplantation. Everolimus (Afinitor, Afinitor Disperz) is approved for treatment of benign brain tumors associated with a rare genetic condition and for treatment of a rare pediatric brain tumor called subependymal giant cell astrocytoma (SEGA). Everolimus is related to sirolimus (Rapamune) and tacrolimus (Prograf, generic), which are also being investigated for brain tumor treatment.

Treatment of Complications

Peritumoral Edema

Edema is swelling due to excess fluid retention. Normal brain tissue next to a tumor can swell and cause more pressure in addition to that from the tumor.

Edema associated with some tumors, particularly medulloblastomas, interferes with the flow of cerebrospinal fluid and causes hydrocephalus (accumulation of fluid in the skull), which in turn causes a build-up fluid in the ventricles (the cavities) in the brain.

Symptoms of peritumoral edema include:

  • Nausea and vomiting
  • Severe headaches
  • Lethargy
  • Difficulty staying awake
  • Seizures
  • Visual impairment
  • Irritability
  • Fatigue
Ventricles of the brain


Corticosteroids (commonly called steroids), such as dexamethasone (Decadron), are used to treat peritumoral edema. Side effects include high blood pressure, elevated blood sugar (glucose) levels, mood swings, an increased risk of infection, stronger appetite, facial swelling, and fluid retention, among others.



Seizures are common in brain tumors, with younger people having higher risks than older ones. Anti-seizure (anticonvulsant) medications, such as lamotrigine or valproic acid, may treat seizures and are helpful in preventing recurrence.

These drugs are not useful in preventing a first seizure, however, and they should not be used routinely to treat people with newly diagnosed brain tumors. Anti-seizure medications should be used only for people who have experienced a seizure.

Anti-seizure medications can interact with some of the chemotherapies used to treat brain cancers, including paclitaxel, irinotecan, interferon, and retinoic acid. People should discuss these interactions with their doctors.

Muscle Weakness

Brain tumors often impair muscle function, including speech and fine motor skills.

Physical and occupational therapists can assist with rehabilitation for muscle weakness. They can also advise on home modifications, assistive devices, and adaptive tools. Speech therapists can help address problems with talking and word comprehension.

Cognitive Function

Brain tumors can affect many aspects of cognitive function. They can cause difficulties with:

  • Memory
  • Processing of information
  • Attention and concentration
  • Visual perception skills

People may face challenges with planning, insight, initiative, and organizational competencies. Cognitive rehabilitation therapists can assist in recovery with various techniques.

Children younger than age 7 (and particularly those younger than age 3 years) have some of the greatest risks for developing long-term cognitive deficits. These problems may result from the tumor and from treatments such as cranial radiation therapy and chemotherapy that penetrates the blood-brain barrier. Parents should make sure that children receive appropriate supportive services and educational accommodation at their schools.

Depression and Stress

Brain tumors can cause mood, personality, and emotional changes. You should discuss emotional as well as physical issues with your health care team. Depression can be treated medically and through psychotherapy. Relaxation techniques can be helpful. Support groups can also have great benefit for both patients and their families.





Deangelis LM. Tumors of the Central Nervous System and Intracranial Hypertension and Hypotension. In: Goldman L and Schafer AI, eds. CecilMedicine. 24th ed. Elsevier Saunders; 2012: chap 195.



Gilbert MR, Dignam JJ, Armstrong TS, Wefel JS, Blumenthal DT, Vogelbaum MA, et al. A randomized trial of bevacizumab for newly diagnosed glioblastoma. N Engl J Med. 2014 Feb 20;370(8):699-708. PMID: 24552317



Lacy J, Saadati H, Yu JB. Complications of brain tumors and their treatment. Hematol Oncol Clin North Am. 2012 Aug;26(4):779-96. Epub 2012 May 18. PMID: 22794283




Patel TR, Yu JB, Piepmeier JM. Role of neurosurgery and radiation therapy in the management of brain tumors. Hematol Oncol Clin North Am. 2012 Aug;26(4):757-77. Epub 2012 May 18. PMID: 22794282

Prabhu RS, Won M, Shaw EG, Hu C, Brachman DG, Buckner JC, et al. Effect of the addition of chemotherapy to radiotherapy on cognitive function in patients with low-grade glioma: secondary analysis of RTOG 98-02. J Clin Oncol. 2014 Feb 20;32(6):535-41. Epub 2014 Jan 13. PMID: 24419119  

Ricard D, Idbaih A, Ducray F, Lahutte M, Hoang-Xuan K, Delattre JY. Primary brain tumours in adults. Lancet. 2012 May 26;379(9830):1984-96. Epub 2012 Apr 16.



van Breemen MS, Wilms EB, Vecht CJ. Epilepsy in patients with brain tumours: epidemiology, mechanisms, and management. Lancet Neurol. 2007 May;6(5):421-30.



Review Date: 12/2/2014

Medical Care

Pregnancy & Prenatal Classes
Weight Loss
Heart Disease
Women's Health
More Medical Care


Immediate Care
Health Centers
Emergency Room
Doctors Offices
Affiliate Hospitals

Patients and Visitors

Pay Your Bill
Request an Appointment
Get Healthy
Support Groups
Fitness Groups
Mobile Applications
Clinical Trials
Online Nursery
Classes and Events
Send an eCard
Patient Stories
Patient and Family Advisory Council
Places to Stay
Say Thanks
Risk Assessments

About Us

Quality Report 
Ways to Help
Community Outreach
Contact Us
(502) 629-1234

Connect with us

© 2015 Norton Healthcare
Serving Kentucky and Southern Indiana