NCCN Guidelines for Patients
Brain Cancer – Gliomas, Version 1.2016
Test and treatment overview
The way chemotherapy is received differs among the
drugs. Some are liquids that are injected into a vein.
Others are made as pills. One drug, carmustine, is
also made as a wafer. Your medical neuro-oncologist
will discuss your options with you. A medical neuro-
oncologist is a doctor who’s an expert in treating
tumors in the nervous system.
Liquid chemotherapy travels in your bloodstream
to treat cancer throughout your body. Likewise,
chemotherapy pills dissolve in your stomach and
enter your bloodstream. Doctors use the term
“systemic” when talking about a cancer treatment for
the whole body.
Systemic chemotherapy is given in cycles of
treatment days followed by days of rest. The cycles
vary in length depending on which drugs are used.
Common cycles are 14, 21, or 28 days long. Giving
chemotherapy in cycles gives your body a chance
to recover after receiving chemotherapy. If you will
have chemotherapy, ask your doctor how many
cycles and days of treatment there are within a cycle.
Some treatments can be placed in the nervous
system where there is cancer. Doctors call this “local
delivery.” Carmustine wafers are placed into the
brain within the space left by the removed tumor. Up
to 8 wafers may be used. They dissolve over time.
Carmustine wafers treat cancer cells that may remain
in the normal-looking tissue that surrounded the
Side effects of chemotherapy
Side effects of chemotherapy depend on many
factors. These factors include the drug, amount
taken, length of treatment, and the person. Some
people have many side effects. Others have few.
Some side effects can be very serious while others
can be unpleasant but not serious. Most side effects
Guide 2. Drug treatment for gliomas
Brand name (sold as)
Type of treatment
Etoposide; Etoposide phosphate Etopophos