[Intra-arterial chemotherapy with ACNU in the treatment of malignant gliomas].
Twelve patients with supratentorial gliomas were treated with intra-arterial ACNU followed by intravenous maintenance chemotherapy. Six of the patients, treated from February 1987 through May 1989, received doses of 120-200 mg/m2 (high dose treatment group); six patients, treated from June 1989 through October 1990, received doses of 80-100 mg/m2 (low dose treatment group). The drug was given via the supraophthalmic portion of the internal carotid artery or vertebral artery at a rate of 10 mg/min. The response rate (CR + PR) on CT scan was 50% (3/6) in the high dose treatment group and 17% (1/6) in the low dose treatment group. Survival periods from first operation, however, did not differ between the high and low dose treatment groups. Bone marrow suppression was dose-related and reversible at these doses. Severe neurotoxicities (hemiparesis and aphasia) developed in the patients who received 200 mg/m2 of ACNU; in one case, this was irreversible. High dose intra-arterial ACNU chemotherapy is effective in reducing tumor size on CT scan but the prognosis is not improved. The dose limiting factor of intra-arterial nitrosourea is neurotoxicity, and doses of more than 200 mg/m2 are considered to be dangerous.
Fujiwara
T
T
Dept. of Neurological Surgery, Kagawa Medical School.
Matsumoto
Y
Y
Tsuchida
T
T
Honma
Y
Y
Mino
S
S
Nagao
S
S
D000328:Adult; D000368:Aged; D001254:Astrocytoma / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology; D001932:Brain Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D002343:Carotid Artery, Internal; D005260:Female; D005909:Glioblastoma / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology; D005910:Glioma / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D007231:Infant, Newborn; D007261:Infusions, Intra-Arterial; D008297:Male; D008875:Middle Aged; D015376:Nimustine / Q000008:administration & dosage / Q000627:therapeutic use*; D011379:Prognosis; D014057:Tomography, X-Ray Computed
D015376:Nimustine