NEUROMODULATION AS A NOVEL APPROACH IN NEURO-ONCOLOGY

Abstract AIMS Neuro-oncology faces significant challenges in treating malignant brain tumours due to their aggressive nature and resistance to conventional therapies. Neuromodulation, which involves the targeted regulation of neural activity using electrical, magnetic or chemical stimulation, has emerged as a potential adjunct or alternative strategy in cancer treatment. Here we explore the applications, mechanisms, and therapeutic potential of neu- romodulation in neuro-oncology. METHODS A systematic review of recent literature was conducted to analyse the role of neuromodulation in brain tumour management. Various techniques, including transcranial magnetic stimulation (TMS), deep brain stimulation (DBS), vagus nerve stimulation (VNS) and tumour-treating fields (TTFields), were evaluated in terms of their efficacy, mechanisms of action and clinical applications. Preclinical and clinical studies were reviewed to de- termine the impact of neuromodulation on tumour progression, neuroprotection and symptom management. RESULTS Emerging evidence suggests that electrical field therapy disrupts cancer cell mitosis, promotes autophagy, im- pairs DNA repair and migration in tumour cells, thereby prolonging survival in glioblastoma. TMS and DBS may represent alternative methods of delivering these effects. Additionally, neuromodulation may enhance drug delivery by modulating the blood-brain barrier, attenuate tumour-associated inflammation and synergise immunotherapy approaches. Neuromodulation associated changes in neurotransmitter signalling may be a further strategy to inhibit tumour propagation. Further, VNS and spinal cord stimulation may have roles in tumour control beyond the central nervous system. However, further large-scale studies are needed to confirm these findings. CONCLUSION Neuromodulation represents a promising adjunctive approach in neuro-oncology, with potential applications in tumour control. Continued research is essential to identify treatment regimes, identify patient-specific benefits, and integrate neuromodulation into oncological care.