This page discusses the use of chemotherapy for the treatment of brain tumors. For a thorough review of chemotherapy for cancer treatment, please see the chemotherapy treatment monograph .

Cancer chemotherapy is the use of drugs to kill cancer cells. Unlike radiation and surgery, which are localized treatments, chemotherapy is a systemic treatment, meaning the drugs travel throughout the whole body. This means chemotherapy can reach cancer cells that may have spread, or metastasized, to other areas.

Chemotherapy is usually given by vein, but some forms can be given by mouth as well. Your medical oncologist will tell you how many cycles or courses of chemotherapy are best for you. Usually there are between 4 and 6 cycles of chemotherapy given when the chemotherapy is delivered on its own, and up to 10 cycles of chemotherapy when the drugs are given along with the radiation therapy.

Chemotherapy for High-grade Brain Tumors

Only the high-grade gliomas qualify for chemotherapy, and chemotherapy is generally given as adjuvant treatment after surgery and radiation . However, in many cases chemotherapy is offered either alone or along with radiation, without a definitive surgery ever being performed. Many times, curative surgery is inappropriate because it would require the removal of brain tissue that controls sensation, movement, or rationale thought; surgeons avoid surgery in these cases as it leaves patients too incapacitated.

The following chemotherapy drugs can be used alone or in combination for certain brain tumors:

For Grade III tumors:

  • Procarbazine
  • Lomustine (CCNU)
  • Vincristine (PCV)

For Grade IV tumors:

  • Carmustine (BCNU)
  • Paclitaxel
  • Temozolomide

Carmustine has been applied directly to the brain in the form of a soluble wafer (called a Gliadel wafer). The theory is that direct application results in higher drug concentrations; unfortunately, the results have been unimpressive.

Overall response to chemotherapy is modest in most younger patients and even less in the elderly.

For more information on chemotherapy, including the side effects and how to manage them, please see the chemotherapy treatment monograph