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49
A NOVEL APPROACH TO TREATING PATIENTS AFTER RESECTION OF MALIGNANT BRAIN
TUMORS: DEVELOPMENT OF A NURSING CARE PLAN. Lisa Bowers, AA, and Mikaela
Olsen, RN, MS, OCN®, Johns Hopkins Hospital, Baltimore, MD.
Traditional treatment of malignant brain tumors involves surgery to remove
the tumor in combination with external beam radiation therapy. If the
tumor cannot be fully resected, treatment includes external bean radiation
therapy with or without chemotherapy. External beam radiation produces
harmful side effects as normal brain tissues are unavoidably affected.
These radiation treatments last approximately six weeks and while initially
effective, tumors often recur. Due to the toxicities associated with external
beam radiation, repeat treatment is not an option for recurrences. A new
novel approach to treating malignant brain tumors after resection is GliaSite.
GliaSite is a unique balloon and catheter device designed to deliver a
radioisotope to the resected tumor bed. An infusion port is located on
one end of the catheter and a balloon at the opposite end. The infusion
port is placed under the skull and the balloon is placed in the tumor
bed. After implantation, the radioisotope is instilled into the balloon
through the port using a non-coring needle. The radioisotope is contained
within the balloon, allowing for emission of radiation through the balloon
wall to the surrounding tissues for a time period of 3–7 days. This
localized treatment targets the tumor bed while minimizing exposure to
healthy tissue, making it an exciting option for malignant brain tumor
patients.
Currently there is limited information available to nurses caring for
GliaSite patients. In this presentation, a comprehensive nursing plan
of care for a unique brain tumor therapy will be described as well as
a review of the technology. The nurse plays a pivotal role in ensuring
patient safety, minimizing radiation exposure to staff and visitors, and
providing patient education and support. Thorough nursing assessment and
prompt nursing intervention are essential in managing this patient population.
Patients are at risk for seizures, mass effect, leakage of radioisotope
from the balloon, and falls. Successful management of this patient population
requires collaboration between the oncology nurse and the neurosurgery
team, the radiation oncology team, and radiation safety. Oncology nurses
should be familiar with this novel device in order to provide appropriate
patient education and to ensure safe, quality care.
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