Brain Tumor Program
Program Overview
As Orange County’s leading brain tumor program (by volume), Hoag
offers a unique multi-modality diagnostic and treatment program for patients
suffering from benign and malignant primary brain tumors, and those with
metastases to the brain.
Experience and expertise are what set Hoag’s Brain Tumor Program
apart. Treating approximately 300 patients with brain tumors each year
(the most in Orange County), Hoag’s neurosurgeons offer a superior
level of experience. And while many hospitals offer craniotomy or stereotactic
radiosurgery, Hoag clinicians specialize in both routine and minimally
invasive surgical brain tumor management as well as Gamma Knife and Cyberknife
stereotactic techniques. They meet in a weekly tumor conference reviewing
treatment options, and are therefore uniquely equipped to approach each
case with a consensus opinion regarding the right treatment modality.
4,810 patients have been treated since the program’s inception.
Hoag Hospital was the first hospital in Orange County to have the Gamma
Knife and the only hospital in Orange County to have all three radiosurgery
options: Gamma Knife Radiosurgery, Cyberknife, and Tomotherapy. Hoag’s
Brain Tumor Program also has the shortest hospital stays for craniotomies.
Dr. Duma, The Pickup Family Neurosciences brain tumor program director,
utilizes a leading-edge technique for radiosurgical treatment of patients
that have GBM (Glioblastoma Multiforme)—the deadliest of all brain
tumors. This technique targets the borders of the lesion spreading away
from the tumor’s epicenter. With this technique, Dr. Duma’s
cumulative results in the treatment of 109 patients since 1998 show significant
increases over expected survival rates



Cyberknife is a non-invasive robotic radiosurgery system that can be used
to treat both neurological sites (i.e the brain and spine) as well as
tumors throughout the body. Because of its unique engineering and freely
moving robotic arm, it can target tumors from hundreds of angles with
sub-millimeter accuracy. In 2015, the Cyberknife at the Newport Beach
Radiosurgery Center/Hoag Hospital (NBRC) continued to be quite busy, treating
hundreds of cancer patients from referral centers across Southern California.
Of these, 117 were neurosurgical cases. Because of the Cyberknife’s
ability to treat extracranial lesions, both brain and spine tumors (malignant
and benign alike) are included in these figures. Dr. Amanda Schwer, a
Hoag- affiliated radiation oncologist, is the medical director for the
Cyberknife at NBRC.


Outcomes


Hoag’s multidisciplinary team of brain tumor specialists is committed
to providing the latest and most effective diagnostic imaging studies,
surgical techniques, clinical research and management strategies for each patient.
Support & Education
Hoag Brain Tumor Program’s weekly academic conference is designed
for all practitioners to present patient cases. This conference determines
the appropriateness of a given patient’s condition for conventional
surgery, Gamma Knife radiosurgery, and/ or other type of oncologic and
medical management.
This conference serves as an “oversight council” forthe proper
objective selection of patients, including acceptability for clinical
research protocols.
Hoag’s Brain Tumor Support Group offers education and support for
anyone diagnosed with a primary brain tumor or metastatic disease. The
group meets on the third Wednesday of every month at 3 p.m. This group
is beneficial for patients, family, and friends.
Hoag is also designated as a teaching center for Stereotactic Radiosurgery
for the UCI Neurosurgical Residency Program annually. It is a three-month
rotation, approved by the Board of Neurologic Surgeons. The program director
is Christopher Duma, M.D.
Team
The Brain Tumor Program is led by Medical Director Christopher Duma, M.D.
The nurse navigatoris Lori Berberet, R.N., M.S. Dr. Duma and Lori are
supported by a team of neurosurgeons,neuroradiologists, neurologists,
radiation oncologists, radiation physicists, RNs, operating room staff,
and researchers.
Clinical Research
Christopher Duma: Northwest Biotherapeutics, Inc. Protocol 020221: A PHASE
II CLINICAL TRIAL EVALUATING DCVax®- Brain, AUTOLOGOUS DENDRITIC CELLS
PULSED WITH TUMOR LYSATE ANTIGEN FOR THE TREATMENT OF GLIOBLASTOMA MULTIFORME (GBM)
Publications, Lectures, Book Chapters
Duma, C., Kim, B., Chen, P., et al. Up-Front Boost Gamma Knife “Leading
Edge” Radiosurgery (LERS) to MR FLAIR- Defined Tumor Migration Pathways
in 174 Patients with Glioblastoma Multiforme: A 15-Year Assessment of
aNovel Therapy.” Accepted for Publication in the Journal of Neurosurgery.
Duma, C, Kano, H., Sheehan, J., Sneed, PK., et al. “Skull base chondrosarcoma
radiosurgery: report of the North American Gamma Knife Consortium”.
Journal of Neurosurgery. 2015 Nov; 123 (5): 1268-75. doi: 10.3171/2014.12
JNS132580 Epub 2015 Jun 26. PMID: 26115468
Duma, C., Ou SH., Klemper, SJ., et al. “Radiation necrosis presenting
as pseudoprogression (PsP) during alectinib treatment of previously radiated
brain metastases in ALK- positive NSCLC: Implications for disease assessment
and management. Lung Cancer. 2015 June; 88(3): 355-9. doi:10.1016/j.lungcan.2015.03.022.
Epub 2015 Mar 30. PMID:25882777
Duma, C., Kano, H., Shuto, T., et al. “Stereotactic radiosurgery
for intracranial hemangioblastomas: a retrospective international outcome
study.” Journal of Neurosurgery. 2015 Jun; 122(6): 1469-78. doi:
10.3171/2014.10.JNS131602. Epub 2015 Mar27. PMID: 25816088
Presentations
Duma, C., Kim, B., Chen, P., et al. Up-Front Boost Gamma Knife “Leading
Edge” Radiosurgery (LERS) to MR FLAIR- Defined Tumor Migration Pathways
in 174 Patients with Glioblastoma Multiforme: A 15-Year Assessment of
a Novel Therapy.” 18th Annual Lesksell Gamma Knife Society Meeting.
Amsterdam – May 15-19, 2016.
Duma, C., Van den Bent, M., Stupp, R., “Pathophysiology of Gliomas
Leading Edge Radiosurgery Emerging Approaches” Panel Debate. 18th
Annual Lesksell Gamma Knife Society Meeting. Amsterdam – May 15-19, 2016.
To learn more, visit the
Brain Tumor Program section or call 949-764-5938, Opt. 4.