{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T20:09:32Z","timestamp":1790107772486,"version":"4.0.1"},"reference-count":43,"publisher":"Scientific Scholar","content-domain":{"domain":["ijmr.org.in"],"crossmark-restriction":true},"short-container-title":["Indian J Med Res"],"abstract":"<jats:sec>\n                    <jats:title>Background and objectives<\/jats:title>\n                    <jats:p>Glioblastoma is the most aggressive primary adult central nervous system of malignancy, with a median overall survival of 12\u201318 months. Recurrence is almost inevitable and carries poor outcomes, with median overall survival of 2\u20139 months and progression-free survival of 1.5\u20136 months. Treatment options are limited, as locoregional therapies apply to selected patients, and systemic treatments are restricted by the blood\u2013brain barrier. Focused ultrasound has emerged as a noninvasive method to transiently and reversibly increase blood\u2013brain barrier permeability. This study aims to systematically evaluate the clinical efficacy and safety of focused ultrasound-mediated blood\u2013brain barrier modulation to enhance drug delivery in recurrent glioblastoma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic search of PubMed, ScienceDirect, Scopus, the Cochrane Library, ClinicalTrials.gov, and Wiley Online Library identified studies published between 2015-2024. The review followed PRISMA guidelines, with risk of bias assessed using ROBINS-I and protocol registration in PROSPERO (CRD420251010548). Disagreements were resolved by consensus.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Twelve clinical trials involving 841 patients met inclusion criteria. Focused ultrasound-mediated platforms included SonoCloud-1, SonoCloud-9, ExAblate Neuro, and NaviFUS, with 1\u201310 sonication sessions lasting 2.5\u201322 min. blood\u2013brain barrier opening was achieved in 68\u2013100% of procedures. Median overall survival ranged from 9.95\u201318 months and median progression-free survival (PFS) from 2.2\u20133.5 months. Several studies reported improved outcomes\n                      <jats:italic>vs<\/jats:italic>\n                      historical chemotherapy-only controls, including progression-free survival-6 rates of 42\u201352%. Adverse events were mostly mild and transient, with &gt;85% graded as Grade 1 and no treatment-related mortality.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation and conclusions<\/jats:title>\n                    <jats:p>Focused ultrasound-mediated blood\u2013brain barrier modulation is a practical therapeutic adjunct that improves intracerebral drug penetration and might extend survival beyond traditional outcomes; providing a noninvasive approach suitable for patients where systemic dose escalation is limited by toxicity and access.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.25259\/ijmr_2529_2025","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T12:12:28Z","timestamp":1782907948000},"page":"19-28","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Focused 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