Chemotherapy for Brain Tumors

Chemotherapy uses drugs to kill cancer cells. They enter the bloodstream and travel through the body. It may be used:

  • After surgery—to kill any leftover tumor cells
  • With radiation therapy if surgery can’t be done
  • For cancer that spreads to the brain from other sites

Chemotherapy is most often given through an IV. It's done in cycles over a set period. But, most can't get to the brain because of the blood brain barrier (BBB). The BBB protects the brain from harm. It can make getting medicines harder.

Other methods to get chemotherapy:

  • By mouth
  • Intrathecal—Placed into the cerebrospinal fluid (CSF). The medicines will be able to reach the tumor inside the BBB.
  • Direct contact—A wafer is placed on or next to the tumor during surgery. The wafer dissolves over time.

Chemotherapy Drugs

There are many kinds of chemotherapy drugs. The choice will be based on the type of tumor and where it's found. Chemotherapy drugs from brain tumors may include:

  • Carboplatin
  • Carmustine (BCNU) or lomustine (CCNU)
  • Cisplatin
  • Procarbazine
  • Temozolomide
  • Methotrexate
  • Vincristine

Side Effects and Management

Chemotherapy causes a range of health problems. The most common are:

  • Nausea or vomiting
  • Feeling tired
  • Mouth sores
  • Hair loss
  • Loss of hunger
  • Diarrhea
  • Low blood cell counts—which can lead to anemia and neutropenia

There are many ways to manage these problems. Medicines and lifestyle changes are the most common. In some cases, the cycles may be changed to lower the chances of serious problems. Talk to your healthcare team as soon as these appear so they can be better controlled.

References:

Astrocytoma and oligodentroglioma in adults. EBSCO DynaMed Plus website. Available at: http://www.dynamed.... Updated May 13, 2016. Accessed August 10, 2018.
Chemotherapy for adult brain and spinal cord tumors. American Cancer Society website. Available at: https://www.cancer.org/cancer/brain-spinal-cord-tumors-adults/treating/chemotherapy.html. Updated November 8, 2017. Accessed August 10, 2018.
Meningioma. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T116926/Meningioma. Updated January 19, 2017. Accessed August 10, 2018.
Overview of intracranial tumors. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/neurologic-disorders/intracranial-and-spinal-tumors/overview-of-intracranial-tumors. Updated June 2018. Accessed August 10, 2018.
Treatment option overview. National Cancer Institute website. Available at: https://www.cancer.gov/types/brain/patient/adult-brain-treatment-pdq#section/_102. Updated July 5, 2018. Accessed August 10, 2018.
Last reviewed June 2018 by EBSCO Medical Review Board Mohei Abouzied, MD, FACP
Last Updated: 8/10/2018

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