Treatment Options:
Physicians often recommend one or more treatment
options based on the patient's tumor type, tumor location, prior
treatment and general health. These options include surgery, radiation,
standard
chemotherapy, intra-arterial chemotherapy, and blood-brain barrier
disruption (BBBD) with intra-arterial chemotherapy.
Surgery:
A craniotomy
is the most common surgical approach to remove brain tumors. The
amount of tumor removed depends on the tumor type, its location in
relation
to surrounding brain structures, and the extent to which it has
spread in the brain.
Yet even if surgery removes most of the tumor,
some microscopic,
rapidly dividing tumor cells still remain. Surgery is not considered
a cure for most brain tumors,
except for certain non-malignant tumors such as meningioma and acoustic neuroma.
Therefore, the patient will need additional treatments after surgery. Surgery
is usually not used if the patient has more than one brain tumor except to
make a diagnosis by obtaining a biopsy.
Radiation:
The goal of radiation therapy is
to destroy cancer cells by injuring their ability to divide. Depending
on their tumor type, patients may receive radiation as their sole
treatment. Radiation and/or radio surgery may also be used before
or after chemotherapy, but our data,
as well as others, show that chemotherapy is more effective prior
to radiation. Our preclinical studies also show that radiation has
fewer side effects when chemotherapy
is done first (Remsen 1995).
Chemotherapy:
Chemotherapy affects tumor cells
by stopping their rapid growth or division. Chemotherapy is given by pill
or injection into a vein, an artery or the cerebral spinal fluid. Because
some drugs work better together, patients often receive more than one
chemotherapy agent. Advantages
of BBBD With Chemotherapy:
Blood-Brain
Barrier Disruption therapy is an intensive, effective method of
delivering chemotherapy to brain tumors. Well-tolerated by the vast
majority of
our patients, BBBD treatment allows the passage of chemotherapy
drugs through the protective barrier that lines the blood vessels of
the brain.
This maximizes the delivery of those drugs to the tumor and brain
around the tumor.
When compared to standard chemotherapy, the BBBD procedure
increases
the delivery of the drugs to the tumor and its surrounding
area by
tenfold to a hundredfold (Neuwelt 1998).
Please
see Institute
for Clinical Systems Improvement report on blood brain barrier
disruption chemotherapy.
Blood-Brain Barrier Program Clinical Trials:
Please see clinical trials for more
information on Blood-Brain Barrier Program studies that are currently
enrolling subjects.
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