[Chemotherapy of malignant brain tumours: principles, difficulties, results and strategies (author's transl)]

Long-lasting therapeutic results have not yet been reached in brain tumour chemotherapy. Mean survival rates in patients with malignant gliomas (glioblastoma multiforme, astrocytoma III-IV) can only be increased for a few months, even with the administration of alkylating nitrosourea derivatives which are in common use these days. In addition to general difficulties of chemotherapy, the well-protected site of the target organ, the brain, is responsible for that fact. This organ has special barrier mechanisms which reduce environmental influences; furthermore the kinetics of brain tumour cells and the interaction of pharmacological agents and tumourous cells are only scarcely known. Finally there are difficulties in the comparison of different samples because criteria of sampling are not always identical and an unequivocal terminology is not used in brain tumour classification. Nevertheless there has been some therapeutic progress after the introduction of urea derivatives into brain tumour chemotherapy, be it as single agent, combination or adjuvant chemotherapy. There is apparently an increase in long-time survivors indicating the effectiveness of the chemotherapeutic scheme in use. Own results with 5 different protocols confirm this tendency. Certain cases with correlations between Ct and post mortem findings are presented. Results and conclusions are discussed.