Gliasite® Radiation Therapy A Patient Guide HF#6225



What is Gliasite^®Radiation Therapy?

 

It is a way to give high doses of radiation to the tumor site and a small amount to normal brain tissue around the tumor.  The radiation source is placed into the tumor area, using a balloon.  The balloon will release the radiation to the tumor site.

The system consists of a tube that connects to a balloon and a valve (see picture).  Iotrex® (a liquid radiation source) is placed into the balloon.  

 

Types of Tumors That May Be Treated

 

Many types of tumors can be treated with this method.

• Malignant gliomas
• Anaplastic astrocytomas (also known as Grade 3 astrocytomas)
• Glioblastoma Multiforme (also known as GBM or Grade 4 Astrocytomas)
• Metastatic tumors (spread to the brain from other parts of the body, such as lung cancer or breast cancer)

 

Before Your Treatment

 

You will need brain surgery to remove as much of the tumor as possible.  The balloon will then be placed into that site.  Once placed, the balloon will be filled with saline and a contrast liquid.  The valve end of the device will be placed on top of the skull bone.  The entire device is under the skin.  You will not be able to see the valve but you will be able to feel it, when you touch your head (see picture).  Your doctors will discuss the procedures and the risks with you.  The day after your surgery, an MRI scan will be done of your head.  The doctors will use this to plan how much radiation to give.

 

You will be sent home when your neurosurgeon decides you are able and asked to return at a later date for the radiation part of the treatment.

 

During the Treatment

 

The CT Scan and Admission to the Hospital

 

On the day you are to start the treatment, you will go to Radiotherapy for a CT (CAT) scan.  If you have never had a CT scan before, please tell your nurse.  You will be given a Health Facts for You that explains it in greater detail.  This scan will be done without the use of contrast.  You will not need to restrict any food or fluid.  The scan will take only a few minutes to complete.  It is the final step before we can begin planning your treatment.

 

Once the CT scan is done, you will be sent to Admissions to complete the registration process.  The staff there will direct you to an inpatient nursing unit.

 

Once you arrive on the nursing unit, the nurse will start an IV and ask you to complete some paperwork.  Sometime later that day, the doctor will come to your room to inject the Iotrex®.

 

Instilling the Iotrex®

 

The doctor will numb the area on your head where the valve is located.  Once this part is numbed, the doctor will remove the contrast or saline, and fill the balloon with the Iotrex®.  A small dressing is then placed over the valve site.

 

While the Solution is Working

 

Once the Iotrex® is instilled, you will not be allowed to leave your room.  The amount of time staff and visitors can spend with you will be restricted.  The amount of time they can spend will be listed on a sign outside your door.  You may want to bring items to help the time pass more quickly (i.e. movies, books, a computer, DVD’s, hobby projects).   

 

Ask visitors to spread out their visits rather than coming in a group.  This allows you to have more time with them, which helps relieve some of the boredom of being in your room.

 

Most often, the Iotrex® needs to stay in your head for about 4 days, but can be as long as 7 days.  

 

Measurements will be made daily to assure that the Iotrex® is in place. 

 

Removing the Iotrex® 

 

To remove the solution, the doctor again will numb the area on your head around the valve.  Once this part is numbed, the doctor will remove the Iotrex® and flush the balloon with normal saline.  The balloon will be flushed and emptied.  Shortly after the solution is removed you are discharged home.  The Gliasite® device will still be in your head.  

Side Effects

 

Most of the time there are few side effects. The most common side effects are listed below.

 

Brain Swelling or Edema

• May occur during treatment or weeks to months after treatment is over.  If this occurs, you will be treated with a steroid medicine to reduce the swelling.
• Symptoms of edema can vary and depend upon the location and type of tumor or lesion you have.  If you have any of these, tell your doctor.  A few of the more common things to watch for include:

• Headaches that are not relieved by Tylenol®

• Nausea or vomiting with or without a headache

• Numbness or tingling of the face, hand, arm, or leg

• Clumsiness of a hand or leg

• Vision, hearing, or speech changes or difficulties

• Balance or walking difficulties or dizziness

• New or worsening seizures

 

Hair Loss

• Hair loss is rare with this type of radiation.  Any hair loss would be temporary.

 

Nausea and Nutritional Needs

• Nausea and vomiting may occur.  This is rare.  Please let your doctor or nurse know so medicines can be ordered for you. Nutrition is important during this time.  Try to eat three servings of protein and drink at least 6-8 glasses of water daily.  If you have further questions, please discuss them with your nurse.  

 

Infection

• Infection may occur at the valve site.  This is very rare.
• Symptoms of infection are listed below. Call your doctor immediately with any of these symptoms.
  • Fever above 100°F for two readings taken 4 hours apart
  • Discharge from the valve site
  • Redness around valve site
  • Stiff neck or difficulty moving head backward or forward
  • Pain with moving head backward or forward
  • Nausea or vomiting with or without headache

 

What are the risks?

 

Your doctor will discuss the short-term and long-term risks of this treatment with you.  The risks vary and depend on a number of factors.  Some of these include: your diagnosis, the size and place of the lesion, dose of radiation used, and your general health.

 

When should I call the doctor?

 

• Headaches that are not relieved by Tylenol®
• Nausea or vomiting with or without a headache
• Numbness or tingling of the face, hand, arm, or leg
• Clumsiness of a hand or leg
• Vision, hearing, or speech changes or difficulties
• Balance or walking difficulties or dizziness
• New or worsening seizures
• Signs of infection
  • Fever above 100°F for two readings taken 4 hours apart.
  • Discharge from the valve site
  • Redness around valve site
  • Stiff neck or difficulty moving head backward or forward
  • Pain with moving head backward or forward
  • Nausea or vomiting with or without headache

 

What do I do if I have questions or problems?

 

If you have any questions or problems once you are at home, call the Radiotherapy Clinic at (608) 263-8500.  If the clinic is closed, your call will be transferred to the hospital answering service.  Ask the operator for the radiotherapy doctor on call.  Give the operator your name and phone number with the area code.  The doctor will call you back.

 

If you live outside of the area, you can call toll-free 1-800-323-8942. 

 

The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.

Last Updated: 01/22/2013

Copyright © 01/22/2013 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#6225

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