Osmotic blood-brain barrier modification for the treatment of malignant brain tumors

The blood-brain barrier (BBB) is a physiologic barrier that protects the brain from toxic substances, including most of the chemotherapeutic agents used today. The BBB may be partly responsible for the poor efficacy of chemotherapy for malignant primary or metastatic brain tumors. A technique of osmotic modification of the BBB, known as BBB disruption (BBBD), is used to increase the delivery of chemotherapy to the brain. This article discusses the technique of osmotic opening of the BBB, the national BBBD program, the role of nurses in the care and management of patients undergoing BBBD treatment, outcomes of this technique with a variety of brain tumors, and the future directions of the BBBD program.