Experience with Blood Brain Barrier Disruption in the Treatment of Malignant Brain Tumor
The blood-brain-barrier (BBB) seems to be a major factor in the paucity of chemotherapeutic agents entering the brain to be effective against the malignant brain tumor. Since systemic treatment with large doses of chemotherapeutic agents provide no benefit, a transient reversible osmotic opening of this barrier is necessary. Intra-arterial infusion of hyperosmolar mannitol into the cerebral tumor area disrupts the BBB and thus immediate intra-arterial infusion of multiple drugs enabled them to reach the tumor in a much higher concentration. This disruptive mechanism and mode of delivery of drug appeared to be the only currently available effective and dependable pathway.
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