Proton Machine I’m getting radiation that is called 3D conformal therapy. Here’s a picture of a machine like the one they use to give me the radiation. It doesn’t look really big in this picture but it weighs like 90 tons and that’s as much as 45 cars! It’s boring being inside, but I only have to be in it for about 20 minutes. I wear a special pink mask that fits my face to hold it really still while it shoots radiation at the tumor in my brain. I can’t feel it or anything! Pieces of radiation are so little I can’t hardly imagine them, but I’ll try to tell you anyway. They use parts of atoms for radiation. If you had an atom that was as big as an Olympic swimming pool, a part of the atom would be about as big as a pinpoint! That’s crazy little!
Here is a picture of the room where they tell the 3D conformal therapy machine what to do. They use computers and it’s really cool. It’s almost like a space station and they can make sure they point the radiation right at the tumor and then they don’t hit anything else. If a person pointed the machine, they might make a mistake, but since they use computers it can be really exact and right on target. They actually take pictures of my brain and everything in my head but when they take the pictures they are like little slices of picture and then the computer puts the slices all together and it comes out looking like a whole brain.
The radiation machine uses two million volts of electricity and it’s weird because I can’t even feel it. Sometimes I get shocked from static electricity but this is way more than that. A regular light bulb only uses 110 volts of electricity and it’s easy to get shocked with that. I don’t really understand how they do it, but they can make this machine shoot radiation into my brain tumor with enough electricity to light up over 18,000 light bulbs and it doesn’t hurt or anything! I stay in the machine about 20 minutes and then that’s all for one day. It makes me tired, but the doctors say that pretty soon it won’t make me so tired. The thing to remember is that it is the best thing to do to make me well.
The doctors are using radiation and chemo to try to get rid of the brain tumor. Radiation is like electricity only a lot more powerful. Chemo is chemicals that they mix up. Some people have to get chemo like a shot, but I get to drink mine. It tastes yukky but I can mix it with milk and that makes it not so bad. The stuff they are giving me has worked on grownups and since I’m almost a teenager they hope it will work on me too. It’s supposed to make the tumor shrink, or at least stop growing. It’s called Vandetanib. I also get 2 kinds of radiation. One is called 3D conformal radiation. They want to use this kind because it is safer for me. They are also doing radiation called Conebeam. It’s a brand new kind of radiation and I’m lucky to get it because it’s supposed to only hit the tumor and not hurt anything around the tumor. You can read all about the medicine and the radiation at the bottom of this page. It’s pretty boring to me and I don’t understand some of it. All I know is, it’s supposed to make me get well! That’s the good part about the medicine and the radiation.

If you are a grownup and one of your kids has a tumor you can read what my parents found out from the doctors. It has alot of stuff I don't really understand. Here is what they found out:

Description of the chemo agent oral medication (Vandetanib) that Brianna is taking for the experimental trial through St. Jude's Clinical Research Study.
Vandetanib is a new experimental drug that will be tested in this research study. Vandetanib has not been approved yet by the Food and Drug Administration (FDA). Studies with vandetanib have shown that it is capable of blocking cell receptors called vascular endothelial growth factor receptor (VEGFR) and epidermal growth factor receptor (EGFR). These receptors send signals to tumor and blood vessel cells to divide and grow. VEGFR is responsible for forming new blood vessels that cause tumors to grow. EGFR has a role in controlling cell growth and the specialization of cells. Some brain tumors depend on these factors in order to grow. Vandetanib may or may not have any effect on the growth of a particular brain tumor. Vandetanib has been tested in adults with cancer and there is evidence that vandetanib can cause some adult tumors to shrink, or at least stop growing. This is the first time that this drug will be tested in children.

***It is the idea that this has worked in adults that has given us hope in that maybe this will be a treatment that can help Brianna and her fight with her type of brain tumor.

St. Jude 3D Conformal Radiation -- Preserving Brain Function
Radiation is one of the most effective treatments for children with brain tumors, yet the threat of its side effects on cognitive development, growth, and academic performance has for decades dissuaded many parents and physicians from using this therapy. But at St. Jude, a three-dimensional approach to treating brain tumors with radiation is challenging the general consensus that radiation treatment for brain cancer is inevitably a tradeoff of life for a loss of cognitive function and normal growth. Dr. Thomas Merchant, a physician in St. Jude’s Department of Radiation Oncology, has made that tradeoff obsolete for many children with brain tumors. We can now give them more effective radiation therapy for brain tumors while preserving their cognitive and physical development. Dr. Merchant left Memorial Sloan-Kettering Cancer Center in New York City to work at St. Jude. Only St. Jude could offer him the opportunity to explore the potential of conformal radiation therapy for pediatric tumors. That’s because at St. Jude could he find the resources and enough young patients to conduct his studies. And while “time-is-money” limitations constrain many research physicians elsewhere, at St. Jude Dr. Merchant is able to spend the many hours needed to prepare for each treatment.

The technique combines CAT scans and MRI to create pictures that a computer then turns into three-dimensional images of the tumor exactly as it appears in the brain. By combining these images with computer-controlled radiation beams and meticulous positioning of the treatment table on which the patient lies, radiation hits the tumor from precisely calculated angles and to precisely calculated depths, obliterating the cancer and sparing healthy tissue. This work represents the adaptation of a radiation therapy technique used for prostate and other adult cancers in order to treat a very limited volume of brain tissue in children. Key to Dr. Merchant’s success was showing how to define the target, how much normal tissue to include or exclude in order to ensure full treatment with minimal damage to healthy tissue, and defining the limits of this technique. Conformal radiation therapy is demanding. It requires many hours of preparation time to define the area to be treated, create the three-dimensional treatment plan, and prepare the radiation equipment (linear accelerator) so the child receives highly targeted treatment. But the extra time and expense pays off as Dr. Merchant is finding they retain cognitive functioning and normal growth patterns.


**When we witnessed this radiation process to see what Brianna's treatments entail, this is where we have stated having an all new appreciation for math and science and the ability of doctors to advance technology to such a level!!

Description-Conebeam Radiation Therapy. Experimental trial for radiation oncology which Brianna is also participating.
By studying, understanding, and possibly eliminating uncertainties related to patient setup and positioning during pediatric radiation therapy, St. Jude researchers hope to improve the delivery of radiation therapy. The results of this study will be used to better target disease and spare tissue that does not need to receive radiation. Subjects enrolled in this study will be assigned a treatment setup technique based on disease site, age group, whether sedation is required during radiation treatment and the position of the patient during the radiation treatment.
There are three types of treatment setup techniques:

  • Low-Dose Mega-Voltage Cone Beam Computed Tomography: a special imaging procedure called Cone-Beam Computed Tomography (CBCT) will be performed.
  • Optical: a bite tray equipped with optical markers will be placed in the subject’s mouth so that positioning information can be monitored continuously. The optical system will be used for patients with cancer in the head and neck region who receive radiation lying on their back without sedation.
  • Ultrasound: the SonArray™ system uses an optical tracking device with 3D ultrasound technology to position the subject so that the area to be radiated is precisely at isocenter (point in space where the main ray of the radiation beams pass), for each fraction (radiation dose spread out over time).

The above information is intended to provide only a basic description about a research protocol that may be currently active at St. Jude. The details made available here may not be the most up-to-date information on protocols used by St. Jude. To receive full details about a protocol and its status and or use at St. Jude, a physician must contact St. Jude directly.