Laser Induced Thermotherapy and Blood-Brain Barrier Changes: A Review

Summary The blood-brain barrier (BBB) prevents the passage of plasma-protein bound chemotherapeutic agents into the CNS, presenting a major obstacle for effective chemotherapy of malignant gliomas. It has previously been shown that Nd:YAG Laser-Induced Thermo Therapy (LITT) is associated with BBB permeability changes. In this paper we briefly review the anatomy of the BBB and pharmacological consequences for the delivery of chemotherapeutic agents to the brain and discuss approaches for opening the BBB for therapeutic purposes. We then analyze the basic mechanisms of LITT-induced BBB changes and address specifically the question of whether LITT-induced disruption of the BBB facilitates a locoregional passage of chemotherapeutic agents into the brain tissue. Finally we review the feasibility of this method as an adjuvant therapeutic modality of adjuvant glioma therapy.