Neuroimaging clinics of North America
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Neuroimaging Clin. N. Am. · Nov 2002
ReviewInnovations in design and delivery of chemotherapy for brain tumors.
Effectiveness of chemotherapy in patients with brain tumors is hampered by the presence of the blood-brain barrier and drug resistance. In recent years, significant progress has been made in devising innovative methods of design and delivery of chemotherapy for brain tumors. This article has surveyed the issues of blood-brain barrier and drug resistance and explored some of the strategies used to circumvent problems associated with chemotherapy failure in patients with brain tumors.
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Assessment of the oxygenation status of brain tumors has been studied increasingly with imaging techniques in light of recent advances in oncology. Tumor oxygen tension is a critical factor influencing the effectiveness of radiation and chemotherapy and malignant progression. Hypoxic tumors are resistant to treatment, and prognostic value of tumor oxygen status is shown in head and neck tumors. ⋯ Quantification of cerebral blood oxygen saturation using MR imaging has promising clinical applications; however, technical difficulties have to be resolved. Blood oxygen level dependent MR imaging is an emerging technique to evaluate the cerebral blood oxygen saturation, and it has the potential and versatility to assess oxygenation status of brain tumors. Upon improvement and validation of current MR techniques, better diagnostic, prognostic, and treatment monitoring capabilities can be provided for patients with brain tumors.