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Brain and Spine Tumors (CNS)

radiation team photoExperienced radiation oncology team at Johns Hopkins specializes in stereotactic radiosurgery.

Treatment of brain and spine tumors is determined by whether or not their origin is in the brain (primary) or if they spread from the brain to other parts of the body (metastatic) and the size of the tumor.

When radiation therapy is needed, our team of radiation oncology specialists, including physicians, medical physicists, dosimetrists, nurses, and therapists, creates an individualized radiation therapy plan developed for the patient’s specific needs in collaboration with a larger multidisciplinary oncology team that diagnoses and treats cancer.

“For patients with brain and spine tumors, we take a multi-disciplinary approach to care. An expert team meets weekly to formally discuss new cases, and team members communicate on a daily basis about each patient and the treatment plan,” explains Lawrence Kleinberg, MD, who specializes in radiation treatments for brain and spinal tumors. 

“The fact that we specialize in treating brain and spine tumors makes us extremely knowledgeable about the best treatment regimens for our patients,” says Kristin Redmond, MD. “We create and offer a variety of protocol and clinical trials that can’t be found elsewhere.”

Radiation therapies

For primary brain and spinal tumors (those that originate in the central nervous system, or CNS), surgery is the most common treatment. Radiation is likely to be recommended when surgery isn’t possible or after surgery, for certain types of tumors, in order to decrease the chance that the tumor may come back or to treat any tumor that may remain.

Metastatic tumors (those that spread to the brain or spine from another part of the body), which are far more common that primary tumors, are often treatable and can be well controlled. Radiation therapy may be recommended to shrink the size of the tumor or to manage pain.

While cancer in children is rare, brain and spinal cord tumors are the third most common type of childhood cancer. Our Pediatric Cancers section offers an overview of radiation treatments for children and teens.

The radiation specialists at Johns Hopkins use two types of radiation treatments for brain and spinal tumors.

External beam radiation is typically given over a period of weeks, sometimes at the same time as chemotherapy. Types of external beam radiation used to treat brain and spine tumors include:

These technologies are often utilized for tumors that may track significantly into nearby areas. Safety is maximized not only by precise aim, but also by dividing the radiation delivered to those areas over multiple days, up to seven weeks.

Stereotactic radiosurgery (SRS) delivers a very targeted high dose of radiation, and is given in one or a few very high doses or smaller doses over a longer period of time. At Johns Hopkins, radiation oncologists use stereotactic radiosurgery, fractionated radiosurgery (FRS), and CyberKnife to treat brain and spinal tumors. This choice is most often used when a well-defined tumor can be treated with limited radiation to nearby areas of the brain or spine.

The safety and well being of our patients and their families are always the primary concern of every member of the radiation oncology team. We have developed a comprehensive safety program that is unique to Johns Hopkins. As an international leader in radiation safety, our standards for safety serve as an example for other academic and community-based radiation practices. Our safety program not only complies with state and national protocols, it goes well beyond those protocols by integrating innovative safety techniques developed by experts on our staff.

Through our clinical research, we offer our patients the most effective and safest therapies available, in addition to clinical trials that patients can choose to participate in.

To find out more about radiation oncology at Johns Hopkins, call 410-502-8000 or e-mail

The Department of Neurosurgery offers an overview of treatment for brain tumors and spine tumors.

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