Conclusions

Chemotherapy has demonstrated modest efficacy for the treatment of selected patients with brain tumors. It is an effective adjunctive therapy for patients with sensitive anaplastic oligodendrogliomas (i.e., deletions of chromosomes 1p and 19q) and certain pediatric tumors (e.g., high-risk medulloblas-toma). However, the majority of high-grade astro-cytomas and other malignant tumors remain insensitive to currently available chemotherapeutic agents. Further work is needed to characterize low-grade oligodendrogliomas and other brain neoplasms according to molecular phenotype and to correlate this information with chemosensitivity and patient survival. New chemotherapeutic agents must be discovered that are more specific and can attack tumor cells at the molecular level of tumorigenesis and tumor angiogenesis. In addition, it is important to further our understanding of brain tumor chemore-sistance and to design improved strategies for counteracting this pervasive problem.

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