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FIGURE 19.1 The stepwise genetic changes needed to progress from a low-grade astrocytoma to a glioblastoma multiforme. (Reprinted with permission from Nature Publishing Group) [5]. See Plate 19.1 in Color Plate Section.

We will describe the technologies being developed to circumvent the barriers encountered in delivering chemotherapeutics to the central nervous system. Special emphasis will be placed on the development of the FDA-approved BCNU-loaded polymer (Gliadel®) for the treatment of malignant tumors. This chapter will review the results and implications of pre-clinical and clinical studies of Gliadel® and other polymer-chemotherapeutic agent systems and describe the surgical technique used to implant Gliadel® wafers at the tumor site. Finally, we will address future directions of local drug delivery for treating brain tumors.

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