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Recurrent Brain Tumors

Note: Some citations in the text of this section are followed by a level of evidence. The PDQ editorial boards use a formal ranking system to help the reader judge the strength of evidence linked to the reported results of a therapeutic strategy. (Refer to the PDQ summary on Levels of Evidence for more information.)

Standard treatment options:

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  1. Surgery alone or in conjunction with chemotherapy.[1,2,3]
  2. Radiation therapy if not previously used, alone or with chemotherapy.
  3. Interstitial radiation therapy.[4]
  4. Chemotherapy.[5]
  5. In a nonrandomized trial of patients with recurrent anaplastic oligodendrogliomas and oligoastrocytomas, significant response rates (i.e., 29% complete response and 29% partial response) were seen with procarbazine, lomustine, and vincristine after radiation therapy.[6][Level of evidence: 3iiiDiv] Time to progression was prolonged in both tumor types.

Treatment options under clinical evaluation:

  • Numerous clinical trials (particularly phase II trials) are evaluating the use of newer drugs in the treatment of brain tumors.
  • Carmustine (BCNU)-impregnated polymer may be implanted during surgery.[7,8]

Current Clinical Trials

Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with recurrent adult brain tumor. The list of clinical trials can be further narrowed by location, drug, intervention, and other criteria.

General information about clinical trials is also available from the NCI Web site.

References:

  1. Salcman M, Kaplan RS, Ducker TB, et al.: Effect of age and reoperation on survival in the combined modality treatment of malignant astrocytoma. Neurosurgery 10 (4): 454-63, 1982.
  2. Rodriguez LA, Levin VA: Does chemotherapy benefit the patient with a central nervous system glioma? Oncology (Huntingt) 1 (9): 29-36, 40-1, 1987.
  3. Young B, Oldfield EH, Markesbery WR, et al.: Reoperation for glioblastoma. J Neurosurg 55 (6): 917-21, 1981.
  4. Leibel SA, Gutin PH, Sneed PK, et al.: Interstitial irradiation for the treatment of primary and metastatic brain tumors. Cancer: Principles and Practice of Oncology Updates 3 (7): 1-11, 1989.
  5. Chinot OL, Honore S, Dufour H, et al.: Safety and efficacy of temozolomide in patients with recurrent anaplastic oligodendrogliomas after standard radiotherapy and chemotherapy. J Clin Oncol 19 (9): 2449-55, 2001.
  6. Brandes AA, Tosoni A, Vastola F, et al.: Efficacy and feasibility of standard procarbazine, lomustine, and vincristine chemotherapy in anaplastic oligodendroglioma and oligoastrocytoma recurrent after radiotherapy. A Phase II study. Cancer 101 (9): 2079-85, 2004.
  7. Brem H, Piantadosi S, Burger PC, et al.: Placebo-controlled trial of safety and efficacy of intraoperative controlled delivery by biodegradable polymers of chemotherapy for recurrent gliomas. The Polymer-brain Tumor Treatment Group. Lancet 345 (8956): 1008-12, 1995.
  8. Brem H, Ewend MG, Piantadosi S, et al.: The safety of interstitial chemotherapy with BCNU-loaded polymer followed by radiation therapy in the treatment of newly diagnosed malignant gliomas: phase I trial. J Neurooncol 26 (2): 111-23, 1995.
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WebMD Public Information from the National Cancer Institute

Last Updated: October 07, 2011
This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.

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