Chemotherapy of brain tumors

Viewed in the light of recent advances and contemporary research, further refinements of surgery and radiotherapy hold little promise for the cure of glioblastomas, although both will continue to have important roles. Immunotherapy has quantitative limitations rendering it ineffective against tumors weighing much more than 1 mg (10(6) cells). Chemotherapy has neither anatomic nor quantitative restrictions, and in theory it has the potential for cure. Laboratory and clinical research have established the activity of several drugs whose important characteristics include penetration of the normal brain and activity against nonproliferating cells. Immediate objectives of current chemotherapeutic research are the identification of newer single agents, the formulation of more effective multiple drug protocols, and ultimately the application of chemotherapy in a multimodality approach to the cure of glioblastomas.