The role of chemotherapy in the treatment of gliomas in adults

摘要: Glioblastomas and previously irradiated recurrent gliomas remain incurable. Chemotherapy is able to palliate patients by shrinking tumors, thereby improving neurological status quality of life. may also be capable prolonging survival in some instances. The effectiveness chemotherapy against comparable the efficacy many other solid tumors. When given an adjuvant setting along with radiation postoperatively, studies suggest that nitrosoureas, dibromodulcitol, dianhydrogalactitol, procarbazine, teniposide, dacarbazine, cisplatin possibly useful, although results for these drugs are inconclusive. Some combinations appear useful setting, particularly BCNU plus ifosfamide, cisplatin, CCNU lonidamine. However, there not yet conclusive evidence combination superior single agent treatment gliomas. While use prior postoperative cranial worthy further study, it has date proven more effective than combined radiation. In whose tumors have recurred following radiation, palliation achieved diaziquone. Cisplatin, high dose methotrexate, interferons, a variety medications use. As case chemotherapy, tumor been conclusively demonstrated treatment, CCNU-based interest. Many different administered intracarotid infusion. There moderately risk serious local retinal toxicity using this approach, improved approach. intraarterial administration warranted light theoretical considerations, pharmacological observations enhanced drug concentrations, observation who failed same intravenously respond when lower doses intraarterially. addition, had shrinkage area infused while grown areas. Thus, must regarded as still investigational potentially quite toxic, indicated. High autologous bone marrow rescue. response rates prolonged durations reported instances, justifying study despite substantial toxicity.(ABSTRACT TRUNCATED AT 400 WORDS)