What is chemo brain

Chemotherapy procedure

In the case of brain tumors, in contrast to other tumor diseases, the cytostatic agent has to overcome an obstacle, the blood-brain barrier. The blood vessels in the brain are particularly "sealed" and thus prevent the transfer of potentially harmful substances from the blood into the brain. This must be taken into account for the treatment of brain tumors, as not all cytostatics cross the blood-brain barrier.


However, especially in glioblastomas, the vessels are changed in such a way that the barrier becomes permeable. This can be recognized, among other things, by the fact that the tumors in the CT and MRT contrast media. When tumor cells are sown in the nerve fluid (liquor), cytostatics can also be administered directly into the liquor space via a reservoir. There is also the option of introducing the cytostatic agent directly into the wound cavity after the operation.


Chemotherapy is performed as part of chemotherapy protocols. These record which substances are used on which days and in which dosage. Since it cannot be assumed that performing the chemotherapy protocol once will kill enough tumor cells, the treatment is repeated; H. carried out in cycles.


The success of the treatment is regularly documented with a physical examination and, in particular, imaging (usually magnetic resonance imaging).


Chemotherapy for brain tumors can be used as the sole therapy or adjuvant, i. H. following surgery or radiation. In rare cases, chemotherapy precedes the operation in neoadjuvant therapy. With simultaneous radiation therapy one speaks of "concomitant", accompanying, chemotherapy.


It happens that the tumor cells do not respond to the cytostatic drug right from the start (primary resistance). This resistance of the tumor can also develop in the course of therapy (secondary resistance). An enzyme (protein), 6-hydroxy-methyl-guanine-methyltransferase (MGMT), plays an important role in resistance. It repairs the DNA damage caused by the therapy and thus counteracts it


What undesirable side effects can chemotherapy have?