Convection Enhanced Drug Delivery of Novel Therapeutic Agents to Malignant Brain Tumors

摘要

In spite of conventional treatment modalities which include surgery, chemotherapy, and radiotherapy, the survivalnrates for patients with malignant gliomas remain disappointing. Successful treatment has been limited by difficultiesnin delivering therapeutic agents to the central nervous system (CNS). Specifically, drug penetration of the blood brain barriern(BBB) poses a unique and challenging problem in glioma therapy. Recently, however, promising techniques havenemerged to circumvent this problem. One such advancement is convection-enhanced delivery (CED). This method wasnoriginally introduced and refined in the early 1990s by researchers at the National Institute of Health (NIH) and involvesndrug infusion under high pressure using intracranial catheters. CED allows for delivery of high concentrations of therapeuticnagents directly into brain tumors and surrounding parenchyma. This method eludes the BBB and allows the use ofnregional drug therapy, while at the same time limiting systemic toxicity. In the present article, we review both the preclinicalnand clinical studies concerning CED. We also discuss future directions and the potential impact of this modalitynon the treatment of malignant gliomas.