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Chemotherapy has difficulty crossing the blood-brain barrier. The blood-brain barrier is a group of tightly woven blood vessels surrounding the brain. This barrier acts as a defense mechanism by not allowing harmful substances to cross into the brain. It does allow some substances to cross the barrier like water, oxygen, hormones, and common anesthetics.  

In recent years, there has been an increased understanding of the biology of DIPG/DMG tumors. New medications are being developed that are tailored to the particular DIPG/DMG tumor characteristics. These developments are showing promise in allowing chemotherapy to aid in treatment. Additionally, researchers have been working on new methods to deliver chemotherapy. These include convection-enhanced delivery (CED), Ommaya reservoir delivery, and focused ultrasound.  These methods help to disrupt the blood brain barrier to allow more chemotherapy agents to pass.

Researchers are optimistic that by discovering the right combination of drugs, dosages, and new delivery methods, they will develop effective treatments for DIPG/DMG in the future, providing more hope for families than ever before. 

Side effects vary depending on the medication, the individual, and the length of treatment. These side effects could include low blood counts, increased risk of infection, fatigue, mouth sores, constipation, decreased appetite, hair loss, confusion, nausea, or vomiting. 

Side effects can usually be reduced with medication given before chemotherapy.