Chemotherapy for malignant gliomas.

An increase in the incidence of malignant gliomas has been noted over the last two decades. Chemotherapy, either adjuvant or at recurrence, has extended the survival of patients with malignant gliomas. Oligodendrogliomas and anaplastic astrocytomas represent the most chemosensitive tumors, while glioblastomas have been relatively resistant to any treatment modality. The most active agents include carmustine, procarbazine, and eflornithine, and combinations such as lomustine, procarbazine and vincristine, or thioguanine, dibromodulcitol, procarbazine, lomustine, fluorouracil and hydroxyurea. Although chemotherapy has demonstrated some efficacy against malignant glioma, new therapeutic strategies are needed for this devastating disease.