Malignant gliomas chemotherapy

Further support for the use of chemotherapy in patients with malignant glioma has been gleaned from meta-analyses. Using the results from 16 randomized clinical trials involving over 3000 patients, Fine et al. compared survival rates of patients who received radiation alone or radiation plus chemotherapy (8). For patients treated on the evaluated trials with radiation only, median survival ranged from 7 to 34 mo, with a median of... 

Several reasons have been cited for the limitations of the use of chemotherapy in the treatment of malignant glioma. Inherent and acquired drug resistance and the lack of good drug penetration through the blood-brain barrier have both been cited as obstacles. Sev-... 

Kirby S, Macdonald D, Fisher B, Caspar L, Cairncross G. Pre-radiation chemotherapy for malignant gliomas in adults. Can J Neurol Sci 1996 23 123-127. 

West CR, Avellanosa AM, Barua NR, Patel A, Hong CL Intraarterial l,3-bis(2-chloroethyl)-l-nitrosourea (BCNU) and systemic chemotherapy for malignant gliomas a follow-up study. Neurosurgery 1983 13(4)420426. 

Johnson DW, Parkinson D, Wolpert SM, Kasdon DL, Kwan ES, Laucella M, Anderson ML. Intracarotid chemotherapy with l,3-bis-(2-chloroethyl)-l-nitrosourea (BCNU) in 5% dextrose in water in the treatment of malignant glioma. Neurosurgery 1987 20(4) 577-83. 

Brem H, Ewend MG, Piantadosi S, et al. The safety of interstitial chemotherapy with BCNU-loaded polymer followed by radiation therapy in the treatment of newly diagnosed malignant gliomas phase I trial. J Neurooncol 1995 26 111-123. 

Westphal M, Hilt DC, Bortey E, et al. A phase 3 trial of local chemotherapy with biodegradable carmustine (BCNU) wafers (Glidel wafers) in patients with primary malignant glioma. Neuro-Oncology (serial online) 2003, 5, Doc. 02-023. Available at http //neuro-oncology.mc.duke. edu. 

Engelhard HH. The role of interstitial BCNU chemotherapy in the treatment of malignant glioma. Surg Neurol 2000 53(5) 458-464. 

Kornblith PL, Walker M. Chemotherapy for malignant gliomas. J Neurosurg 1988 68 1-17. 

Rhines LD, DiMeco F, Lawson HC, Tyler BM, Hanes J, Olivi A, Brem H. Local immunotherapy with interleukin-2 delivered from biodegradable polymer microspheres combined with interstitial chemotherapy A novel treatment for experimental malignant glioma. Neurosurgery 2003 52 1-8. 

For more than 20 years the mainstay of single-agent chemotherapy for malignant glioma of the brain was intravenous 1,3-bis (2-chloroethyl)-l-... 

Fig. 3 Polymer-laden drug delivery. Following resection of a malignant glioma, up to eight carmustine (BCNU)-polymer wafers are placed within the tumor cavity. As the wafers dissolve, they release BCNU locally and provide direct delivery of chemotherapy to the tumor cavity. Figure and text were reprinted, with permission [57]...

Beta DA, Desjardins A, Quinn JA, Affronti ML, Friedman HS. Interstitial chemotherapy with biodegradable BCNU (Gliadel) wafers in the treatment of malignant gliomas. Ther Clin Risk Manag 2007 3 707-715. 

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