The treatment of brain tumors

The treatment of brain tumors can be divided into surgery, radiation therapy, and chemotherapy.

Surgery
Be surgical resection for primary tumors, as much as possible of the tumor cells removed, to avoid cell proliferation is still the most common mode of treatment. Surgical resection, studies indicate that the use of 5-aminolevulinic acid (5-ALA) calibration of cancer cells, it appeared fluorescent, can help enhance the rate of tumor resection, now product Gliolan (medac GmbH) Get approved for sale in Europe. Tumor for the the deeper tumor or can not be removed with traditional open surgery, stereotactic radiosurgery (Gamma knife, Cyberknife or Novalis Tx radiosurgery) is another surgical choice.
For benign tumors, the higher the probability of using complete surgical resection, the patient's survival rate is also higher, such as the brain or cerebellar stellate cell tumor of the sella craniopharyngioma, Choroid plexus tumors, etc., without radiation or chemotherapy treatment, recurrence probabilities are low, but need regular re-examination of CT or MRI. Failed to surgical total removal of residual benign tumor visualization be observed track, then use chemotherapy or radiation therapy.
For malignant brain tumors in general, such as degenerative astrocytoma, medulloblastoma, intraventricular meningioma, teratoma, complete resection or nearly complete resection, the prognosis is better, but must be coupled with radiation therapy and or chemotherapy, so as to achieve the purpose of controlling tumor growth.
Early onset brain tumor patient survival and tumor type and age of the patient and the physiological function have considerable relevance, these factors will influence patient choice of treatment mode.

Chemotherapy
Cancer chemotherapy has made great progress, but due to the special structure of the brain, the blood-brain barrier (BBB), the chemical treatment of brain tumors is still subject to many restrictions, any chemotherapy drugs can only be through the lipid solubility of the drug through the intimal cells , and then into the tumor cells to produce an effect, this mode affects the speed and efficiency of drug action.
Chemotherapy drugs commonly used in clinical nitrosourea alkylating agent BCNU and CCNU, or program with PVC (procarbazine + vincristine + CCNU) have a certain effect, but delayed and cumulative bone marrow suppression and pulmonary toxicity side effects, easy to produce drug resistance.
In the the chemotherapy drug research and development of novel treatment of brain tumors, have made new progress. One is oral medication "Temozolomide", the other is the direct implantation surgery drugs wafer Gliadel (BCNU).
Temozolomide (temozolomide) (schering-plow)
Temozolomide is one having anti-tumor activity, ring containing imidazol-four-triazine (imidazotetrazine) of the alkylating antineoplastic agents. Itself and no activity is a prodrug required under physiological levels PH transformed by the non-enzymatic pathways of the active compound MITC (5 - (3 - methyl-triazene -1 - yl) imidazole-4 - amide), The latter further hydrolyzed into its active metabolites in order to show anti-tumor activity. Theoretically, MTIC the anti-tumor activity is mainly generated by the sixth bit oxygen atom and guanine major role in the alkylation, but also occurs with the seventh bit of the nitrogen atom of guanine secondary additionally alkylation therefore ensuing cell toxicity is considered to be related to the of these abnormalities repair methyl compound.
Temozolomide oral administration, radiation therapy can be used to synchronize adjuvant therapy for the treatment of newly diagnosed glioblastoma multiforme tumors or recurrent malignant gliomas, in the course of treatment should be closely monitored during chemotherapy neutrophils as well as the number of platelets, and avoid the side effects of hematologic toxicity.
Gliadel carmustine implant piece (U.S. Baibo Medicine)
U.S. FDA approval in 1996, developed by Guilford, BCNU as the active ingredient, poly phenylpropionate born 20 release matrix made of the implantation of drug-chip Gliadel, applications for the treatment of recurrent malignant brain tumors after surgery, the drug placed directly in recurrent glioblastoma brain tissue, the drugs slow release, continuing chemotherapy. After years of multi-center clinical trials, the FDA in 2003 to increase its therapeutic indications, approved Gliadel used for the treatment of primary malignant brain tumors, According to literature reports, Gliadel may be extended to the middle of the primary and recurrent malignant brain tumor patients survival.
The treatment is unique in its mode of administration and release system. During a surgical procedure, the first in the tumor tissue excised, leaving a small cavity, and then implant such periodic release of the wafer. These chips will be within 2 to 3 weeks and slowly decompose, melt, releasing the drug directly into the tumor area, killing those in the surgical excision of the tumor cells, and can not harm other organizations under the local lesion to achieve effective blood concentration, slow down the progression of the disease.
American Cancer Alliance (National Comprehensive Cancer Network, NCCN) pointed out that the latest principles of treatment for a malignant brain tumor. Primary and recurrence in patients with malignant brain tumors can be the surgical removal of the tumor at the same time placed Gliadel (BCNU), postoperative supplemented radiation treatment or Temozolomide chemotherapy medication, it was reported in the literature, this mode of treatment can effectively extend the median survival of patients.

Radiation therapy
The radiation treatment is the use of radiation or γ-rays, high-speed neutron rays on tumor cell kill, referred to as radiotherapy.
The radiation therapy is the most common tumor adjuvant therapy means, generally 1-2 weeks after surgery. Radiation therapy using tumor cells more sensitive to radiation, to kill tumor cells susceptible to radiation damage, general treatment takes about four to eight weeks, depending on different tumor pathological diagnosis, degree of differentiation and imaging results of medical examination and decided irradiation The size and dose. Many malignant and the deep parts benign tumor can not be safely removed, radiation therapy is an effective method. Radiation therapy has to with shaped or positioned the way, including the linear accelerator radiation therapy, Gamma ray radiosurgery photon knife. However, some malignant brain tumors remains to be done to a wide range of brain radiation therapy or full cranial and spinal radiation therapy.
Published in 2008 by the Texas Anderson Cancer Center study noted that patients receiving stereotactic radiosurgery (stereotactic radiosurgery; SRS) and whole brain radiation therapy (whole brain radiation therapy; WBRT) for patients with learning and memory damage greater side effects risk.