Locoregional therapies for glioma.

Glioma is the most common form of primary brain tumor, as well as the most lethal. Primary treatment strategies for glioma, including cytoreductive surgery, external-beam irradiation, and systemic chemotherapy have had generally disappointing results for these tumors. Limitations of these approaches include tumor invasion into functional brain tissue, lack of chemosensitivity, and shortcomings of systemic delivery. Recent attention has focused on locoregional strategies for treatment, as well as new methods for delivering therapy. Identification of tumor-specific surface targets, biologic agents, and more sophisticated means to deliver macromolecules to the brain is offering new promise in the treatment of these tumors. This paper will review the current state of the art of available locoregional therapies for glioma, with a particular focus on convection-enhanced delivery, targeted toxin, and other biologic strategies.