Chemotherapy for Adult Brain and Spinal Cord Tumors

Chemotherapy (chemo) uses anti-cancer drugs that are usually given into a vein (IV) or taken by mouth. These drugs enter the bloodstream and reach almost all areas of the body. However, many chemo drugs are not able to enter the brain and reach tumor cells.

For some brain tumors, the drugs can be given directly into the cerebrospinal fluid (CSF), either in the brain or into the spinal canal below the spinal cord. To help with this, a thin tube known as a ventricular access catheter may be inserted through a small hole in the skull and into a ventricle of the brain during a minor operation (see the Surgery for adult brain and spinal cord tumors section).

In general, chemotherapy is used for faster growing tumors. Some types of brain tumors, such as medulloblastoma and lymphoma, tend to respond better to chemotherapy.

Chemotherapy is most often used along with other types of treatment such as surgery and/or radiation therapy. Chemo may also be used by itself, especially for more advanced tumors or for tumors that have come back after other types of treatment.

Some of the chemo drugs used to treat brain tumors include:

  • Carboplatin
  • Carmustine (BCNU)
  • Cisplatin
  • Cyclophosphamide
  • Etoposide
  • Irinotecan
  • Lomustine (CCNU)
  • Methotrexate
  • Procarbazine
  • Temozolomide
  • Vincristine

These drugs can be used alone or in various combinations, depending on the type of brain tumor. Doctors give chemo in cycles, with each period of treatment followed by a rest period to give the body time to recover. Each cycle typically lasts for a few weeks.

Carmustine (Gliadel®) wafers

These dissolvable wafers contain the chemotherapy drug carmustine (BCNU). After the surgeon removes as much of the brain tumor as is safe during a craniotomy, the wafers can be placed directly on or next to the parts of the tumor that can’t be removed. Unlike IV or oral chemotherapy that reaches all areas of the body, this type of therapy concentrates the drug at the tumor site, producing few side effects in other parts of the body.

Possible side effects of chemotherapy

Chemo drugs attack cells that are dividing quickly, which is why they often work against cancer cells. But other cells, such as those in the bone marrow (where new blood cells are made), the lining of the mouth and intestines, and the hair follicles, also divide quickly. These cells are also likely to be affected by chemotherapy, which can lead to side effects.

The side effects of chemo depend on the type of drugs, the amount taken, and the length of treatment. Possible side effects can include:

  • Hair loss
  • Mouth sores
  • Loss of appetite
  • Nausea and vomiting
  • Diarrhea
  • Increased chance of infections (from having too few white blood cells)
  • Easy bruising or bleeding (from having too few blood platelets)
  • Fatigue (from having too few red blood cells, changes in metabolism, or other factors)

Some of the most effective drugs against brain tumors tend to have fewer of these side effects than other common chemo drugs. Most side effects tend to be short-term and go away after treatment is finished. There are often ways to lessen these side effects. For example, drugs can be given to help prevent or reduce nausea and vomiting.

Along with the risks above, some chemo drugs can cause other, less common side effects. For example, cisplatin and carboplatin can also cause kidney damage and hearing loss. Your doctor will check your kidney function and hearing if you are given these drugs. Some of these side effects might last after treatment is stopped.

Be sure to report any side effects while getting chemotherapy to your medical team so that you can be treated promptly. In some cases, the doses of the drugs may need to be reduced or treatment may need to be delayed or stopped to prevent the effects from getting worse.

To learn more about chemotherapy, see the Chemotherapy section on our website.

The American Cancer Society medical and editorial content team
Our team is made up of doctors and master’s-prepared nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Last Medical Review: March 5, 2014 Last Revised: January 21, 2016

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