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J Clin Neurosci. 2016 Apr;26:26-32. doi: 10.1016/j.jocn.2015.10.019. Epub 2016 Feb 5.

Endovascular therapies for malignant gliomas: Challenges and the future.

Author information

1
Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, USA.
2
Department of Neurological Surgery, University of California San Francisco, 505 Parnassus Avenue, Room M779, San Francisco, CA 94143-0112, USA.
3
Department of Neurological Surgery, University of California San Francisco, 505 Parnassus Avenue, Room M779, San Francisco, CA 94143-0112, USA. Electronic address: Omar.Choudhri@ucsf.edu.

Abstract

Malignant gliomas are very difficult tumors to treat, with few effective therapies, early progression and high rates of recurrence. Here we review the literature on malignant gliomas treated with endovascular therapy. Endovascular therapy for malignant gliomas falls into one of three categories: (1) neoadjuvant embolization and devascularization; (2) direct intra-arterial drug delivery; and (3) disruption of the blood-brain barrier for improved intra-arterial drug delivery. There is a range of therapeutic benefits based on the endovascular intervention used. Challenges remain for those who aim to treat malignant gliomas with an endovascular approach. Specifically, embolization is difficult to accomplish in the small vessels that feed into malignant gliomas, and intra-arterial chemotherapy has yet to prove itself better than traditional intravenous chemotherapy. However, there exists promise in the therapeutic potential of intra-arterial chemotherapy paired with disruption of the blood-brain barrier at tumor-specific sites, and as such, continued research to optimize this approach is expected to yield benefit for patients with malignant gliomas.

KEYWORDS:

Anaplastic glioma; Blood-brain barrier; Endovascular; GBM; Glioblastoma; Malignant gliomas

PMID:
26857294
DOI:
10.1016/j.jocn.2015.10.019
[Indexed for MEDLINE]

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