Application of Convection-Enhanced Drug Delivery in the Treatment of Malignant Gliomas

World Neurosurg. 2016 Jun:90:172-178. doi: 10.1016/j.wneu.2016.02.040. Epub 2016 Feb 17.

Abstract

Convection-enhanced delivery (CED) is a promising new method of local drug delivery therapy for a diverse type of antitumor agents. CED offers significant advantages over systemic chemotherapy by bypassing the blood-brain barrier and obtaining adequate drug concentration with limited systemic toxicity. Actually, there is no effective treatment of malignant gliomas (MGs); survival rates remain poor despite decades of clinical trials. Conventional chemotherapy has been found to be minimally effective in the control of MG progression. CED involves the implantation of catheters through which conventional and novel therapeutic formulations can be delivered directly to the tumor using continuous, low-positive-pressure bulk flow. On the basis of the preclinical and clinical studies, we demonstrated that CED could produce effective drug delivery to large brain and tumor areas. However, clinical studies to date have not found any substantial improvement in overall survival in the treatment of MG. This overview presents up-to-date clinical results in the treatment of MG by the application of CED.

Keywords: Convection-enhanced delivery; Local therapy; Malignant gliomas.

Publication types

  • Review

MeSH terms

  • Brain Neoplasms / drug therapy*
  • Brain Neoplasms / pathology
  • Catheterization, Peripheral / instrumentation
  • Catheterization, Peripheral / methods*
  • Delayed-Action Preparations / administration & dosage*
  • Equipment Design
  • Evidence-Based Medicine
  • Female
  • Glioma / drug therapy*
  • Glioma / pathology
  • Humans
  • Infusions, Intralesional / instrumentation
  • Infusions, Intralesional / methods*
  • Male
  • Treatment Outcome

Substances

  • Delayed-Action Preparations