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Neurosurgical
Delivery of Chemotherapeutics, Targeted Toxins, Genetic and Viral Therapies in
Neuro-Oncology
E. Antonio Chiocca,
William C. Broaddus,
George T. Gillies,
Therese Visted,
Martine L.M. Lamfers
Molecular Neuro-Oncology Laboratories, Neurosurgery Service, Massachusetts
General Hospital, Harvard Medical School, Charlestown, MA, USA [E.A.C., T.V., M.L.M.L.].
Department of Neurosurgery, Medical College of Virginia Hospitals, Virginia
Commonwealth University, Richmond, USA [W.C.B.].
Department of Biomedical Engineering, University of Virginia, Charlottesville,
VA, USA [G.T.G.]. Present address:
Department of Neurological Surgery, The Ohio State University Medical Center,
Columbus, OH, USA [E.A.C.].
Local
delivery of biologic agents, such as gene and viruses, has been tested
preclinically with encouraging success, and in some instances clinical trials
have also been performed.
In addition, the positive pressure infusion of various
therapeutic agents is undergoing human testing and approval has already been
granted for routine clinical use of biodegradable implants that diffuse a
chemotherapeutic agent into peritumoral regions.
Safety in glioma patients has
been shown, but anticancer efficacy needs additional refinements in the
technologies employed.
In this review, we will describe these modalities and
provide a perspective on needed improvements that should render them more
successful.
Keywords: brain
delivery methods, convection-enhanced delivery, gene therapy, immunotoxins,
oncolytic virus, toxins, viral therapy
Copyright
©
2004 Kluwer Academic Publishers.
All rights reserved
Source: http://ipsapp007.kluweronline.com/IPS/content/ext/x/J/5042/I/124/A/7/abstract.htm
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