Chemotherapy drugs for brain tumours

• A quick guide to what's on this page
• Chemotherapy drugs for brain tumours
• Chemotherapy for children with brain tumours

Not all chemotherapy drugs are suitable for treating brain tumours. This is because most chemotherapy drugs cannot cross the blood - brain barrier. But some drugs can, including

• Carmustine (BCNU)
• Lomustine (CCNU)
• Procarbazine
• Temozolomide
• Cisplatin and carboplatin
• Methotrexate
• Etoposide
• Cyclophosphamide
• Ifosfamide
• Vincristine
• Other

Temozolomide, procarbazine and lomustine are all made as capsules or tablets, so you can take them by mouth. That means you can have your treatment at home, as an outpatient.

Procarbazine

Your specialist may suggest procarbazine on its own or in combination with other chemotherapy drugs. The most widely used combination for brain tumours is PCV, which is procarbazine, lomustine (CCNU) and vincristine. The commonest side effects of procarbazine are

• A fall in your blood cell counts
• Feeling and being sick
• A flu-like syndrome with headache, temperature, aching and tiredness
• Central nervous system effects, such as anxiety, depression, nightmares, sleeplessness and lack of energy

Procarbazine can react with alcohol, making you sick, dizzy or breathless. So, when you are taking this drug (and for 2 weeks afterwards) it is not a good idea to drink. More rarely, procarbazine can react with particular foods. As this is rare, you can try eating any of these, but it is a good idea to have a small amount at first to see if you are going to react. There is more about this, and about all the side effects of procarbazine in the main chemotherapy section of CancerHelp UK.

Carmustine (BCNU)

You can have carmustine into a vein, through a drip. If you are having it on its own, it is most common to have it every 6 weeks. Or you may have it in combination with other chemotherapy drugs. The commonest side effects are

• Fall in your blood cell counts
• Feeling and being sick
• Pain in your vein while having the drip
• Diarrhoea
• Headache

You can also have carmustine as small wafers implanted into your brain during surgery. Side effects of carmustine implants might include

• Swelling of the brain (oedema)
• Convulsions
• Problems with wound healing
• Infections at the operation site

There is a page on the specific side effects of carmustine in the main chemotherapy section of CancerHelp UK.

Lomustine (CCNU)

This drug comes as a tablet. You usually take a single dose every 6 weeks. You may have it in combination with other drugs. The commonest side effects include

• Fall in your blood cell counts
• Feeling and being sick
• Reaction with alcohol or other drugs
• Loss of appetite

There is a page on the specific side effects of lomustine in the main chemotherapy section of CancerHelp UK.

Temozolomide

Temozolomide is used on its own to treat brain tumours. It can be used to treat newly diagnosed glioblastoma multiforme tumours in people who are fairly fit and well. It is also used for brain tumours that have come back after they were first treated. The commonest side effects include

• A fall in your blood cell counts
• Sickness
• Tiredness
• Sensitivity to the sun

There is a page on the specific side effects of temozolomide in the main chemotherapy section of CancerHelp UK.

PCV

This is a common combination of drugs for treating brain tumours. There are 3 drugs: procarbazine, lomustine (CCNU), and vincristine. As well as the side effects listed above for procarbazine, the commonest side effects for this combination include

• Constipation
• Hair loss
• Numbness and tingling in hands and feet

There is a page on the specific side effects of PCV in the main chemotherapy section of CancerHelp UK.

Other drugs that can be used

Methotrexate injected into the spinal canal can be used to treat some brain tumours, particularly lymphomas in the brain or spinal cord. This type of treatment can cause

• Headache
• Sickness
• Temperature

Headache and sickness are the most common side effects. They can start almost as soon as the drug is given to you. You have to stay lying down for at least an hour after you have had your injection, to make sure that the chemotherapy can circulate around your brain. Very rarely, this type of treatment can cause fits (jerking of arms and legs and short period of unconsciousness). This is rare, so if you are worried by it, ask your doctor for reassurance.

Pineal germinomas are tumours that are similar to some types of cancer of the testicle or ovary. So they are treated with drugs that these types of tumours respond to. Your specialist will of course, decide your exact treatment. But the drugs given could include any of these

• Cisplatin
• Bleomycin
• Vinblastine
• Actinomycin D (Dactinomycin)
• Cyclophosphamide

Young children with primitive neuroectodermal tumours, ependymomas or gliomas may have chemotherapy instead of radiotherapy for some types of brain tumour. This is so that they do not have to have radiotherapy at a very young age. Your child's specialist will decide the exact treatment, but the drugs used can include

• Cyclophosphamide
• Vincristine
• Cisplatin
• Etoposide
• Carboplatin
• High dose methotrexate

Click on the links for information about the side effects of these drugs.