| | The next step, depending on the type and grade of the tumor, is radiation therapy, which consists of using high-energy X-rays many times more powerful than a normal chest X-ray to destroy the ability of cells to grow and divide. Several institutions are employing a "watch and wait" method for low-grade tumors. All malignant tumors, with the exception of anaplastic oligodendriomas, are treated with radiotherapy. Radiation is also the first-line therapy for brain tumors that cannot be removed surgically, such as brain stem gliomas.
There are a number of methods for delivering radiation to the tumor. In external beam radiation, the dosage of X-rays is directed at the tumor from outside the body. The gamma knife is a form of external radiation that is focused at a single point, and may be used to treat smaller tumors. Brachytherapy or interstitial therapy, in which a capsule containing radioactive material is placed inside the brain near to or within the tumor, may also be used.
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