Chemotherapy for brain tumours

Chemotherapy is a drug treatment used to destroy cancer cells. It’s used to treat some brain tumours and can also be given if a tumour comes back.

The main chemotherapy drugs used are:

  • temozolomide (Temodal®)
  • lomustine, procarbazine or vincristine - on their own, or together.
  • carmustine.

You have some of these as tablets. Others are given by injection into a vein (intravenously) which the nurses give you in a chemotherapy day unit. After your session of chemotherapy is finished, you have rest period of a few weeks before you have chemotherapy again. The session and the rest period is is called a cycle of treatment. Your doctor or nurse will explain how you will have chemotherapy and how long it will last.

Another way of giving chemotherapy is by placing an implant containing a chemotherapy drug directly into the brain. As the implant dissolves the drug is released into the brain.

Some people have the chemotherapy drug temozolomide at the same time as radiotherapy. This causes more side effects so you need to be well enough to have it.

What is chemotherapy?

Chemotherapy uses anti-cancer (cytotoxic) drugs to destroy cancer cells. Cytotoxic means toxic to cells. These drugs affect the way cancer cells grow and divide, but they also affect normal cells.

Chemotherapy may be given:

  • with radiotherapy or on its own, to treat a high-grade (grade 4) glioma
  • if a brain tumour comes back after surgery and radiotherapy
  • after surgery instead of radiotherapy, if a low-grade glioma has not been completely removed.

Chemotherapy may be the main treatment for a lymphoma that starts in the brain, called a CNS lymphoma.

We have more information about CNS lymphomas. We also have information about chemotherapy, different chemotherapy drugs and their particular side effects.

The drugs given

There are many different chemotherapy drugs but not all of them can be used to treat brain tumours. Doctors use drugs that are able to pass through the brain’s natural protection (called the blood-brain barrier) into the brain and spinal cord.

The main drugs used to treat primary brain tumours are:

There are different ways of giving chemotherapy for brain tumours. The drugs temozolomide, lomustine and procarbazine are taken as tablets. Vincristine and carmustine are liquids that are given into a vein (intravenously).

To have intravenous chemotherapy, you will need to go to a chemotherapy day unit. A nurse will give it to you as one or more sessions of treatment. You will then have a rest period of a few weeks. The chemotherapy session and the rest period is called a cycle of treatment. The length of a cycle depends on the chemotherapy drugs you’re taking. Most cycles are 4–6 weeks long. Your doctor or nurse will explain more about this. Most courses of chemotherapy are six cycles.

Chemotherapy given along with radiotherapy

If you have a newly diagnosed high-grade glioma, you may be treated with temozolomide and radiotherapy together. This is called a combined treatment. You will need to take temozolomide every day during your course of radiotherapy, which usually lasts for six weeks.

Combined treatment causes more side effects so you need to be physically well enough to cope with it. You also have more risk of getting a chest infection. To reduce the chance of this happening, your cancer doctor will prescribe antibiotics for you to take.

When you’ve finished the combined treatment, you will have a break from treatment. You then start taking temozolomide for five days every four weeks, for six cycles.

Chemotherapy implants

Chemotherapy can be given directly into the brain. A surgeon puts something called a Gliadel® implant or wafer into the brain. The implant contains the chemotherapy drug carmustine. This is sometimes done in people with a newly diagnosed high-grade glioma during surgery. The wafers dissolve over 2–3 weeks and the drug is slowly released into the brain. You may be given a course of radiotherapy treatment as well.

The chemotherapy drug can cause some side effects and having the implant may increase the possible complications of surgery. Although only a very small amount of the chemotherapy gets into your blood, it can make you more likely to get an infection.

We're still working to get some of our information ready for our new site, so in the meantime you can see more information about Gliadel® implants on our current site.

Back to Chemotherapy explained

How do chemotherapy drugs work?

Chemotherapy drugs work by stopping cancer cells reproducing. The drugs can also affect healthy cells, causing side effects.