Local delivery methods of therapeutic agents in the treatment of diffuse intrinsic brainstem gliomas

Clin Neurol Neurosurg. 2016 Mar:142:120-127. doi: 10.1016/j.clineuro.2016.01.007. Epub 2016 Jan 11.

Abstract

Brainstem gliomas comprise 10-20% of all pediatric central nervous system (CNS) tumors and diffuse intrinsic pontine gliomas (DIPGs) account for the majority of these lesions. DIPG is a rapidly progressive disease with almost universally fatal outcomes and a median survival less than 12 months. Current standard-of-care treatment for DIPG includes radiation therapy, but its long-term survival effects are still under debate. Clinical trials investigating the efficacy of systemic administration of various therapeutic agents have been associated with disappointing outcomes. Recent efforts have focused on improvements in chemotherapeutic agents employed and in methods of localized and targeted drug delivery. This review provides an update on current preclinical and clinical studies investigating treatment options for brainstem gliomas.

Keywords: Brainstem glioma; Chemotherapy; Convection-enhanced delivery; Interstitial continuous infusion; Intranasal delivery; Tumor.

Publication types

  • Review

MeSH terms

  • Animals
  • Antineoplastic Agents / therapeutic use*
  • Brain Stem Neoplasms / pathology
  • Brain Stem Neoplasms / surgery*
  • Drug Delivery Systems / methods
  • Glioma / pathology
  • Glioma / surgery*
  • Humans
  • Treatment Outcome

Substances

  • Antineoplastic Agents