CONDITIONS TREATED
Treatment of tumours > Chemotherapy
For reasons which are still not wholly understood, malignant brain tumours do not respond very well to chemotherapy. That being said, some tumours are more amenable to this treatment than others. Oligodendrogliomas, in particular, can be quite chemo-sensitive and chemotherapy is often used in their treatment, as an adjuvant therapy alongside surgery and radiotherapy.
Although many different cytotoxic drugs are used in the treatment of cancer in other organs, most are unable to pass through the blood brain barrier, so very few are suitable for brain tumours. The standard chemotherapy regime used in neuro-oncology involves a combination known as PCV (Procarbazine, CCNU and Vincristine). Treatment with PCV is a relatively gentle form of chemotherapy, involving only one injection and a short course of two tablets per cycle, and side effects that are generally less unpleasant than those associated with other chemotherapy regimes.
Patients with malignant gliomas, especially those with recurrent tumours, may also be offered chemotherapy, although it is only effective in about 5%-6% of cases. A very interesting new development in the treatment of these tumours is the use of Gliadel© wafers to deliver extremely high doses of the cytotoxic drug carmustine (BCNU) directly to the tumour site following surgery. Whilst this method does not offer a cure, early results seem to show that it can provide a significant increase in survival rates, with minimal side effects.
Temazolomide is now also used as a "second line" treatment for some patients with recurrent malignant gliomas, although its efficacy seems to be more limited than was at one stage hoped.