Treatment of malignant gliomas with surgery, intraarterial chemotherapy with ACNU and radiation therapy.
Forty patients with malignant supratentorial gliomas received iterative intraarterial (IA) infusions of ACNU, 1-(4-amino-2-methyl-5-pyrimidinyl)methyl-3-(2-chloroethyl)-3-nitrosourea at a dose of 150 mg repeated every 6 weeks. Group A consisted of eighteen patients previously treated with surgery, radiation therapy (RT) and sometimes chemotherapy, who received IA ACNU at tumor recurrence. Group B consisted of twenty two patients who received IA ACNU in the postoperative pre-RT period. In group A, 8/18 patients (44%) had an objective response, including 6/12 anaplastic astrocytomas (AA) and 2/6 glioblastoma multiforme (GBM), while 10/18 patients (56%) did not respond. Median survival time was 6 months for GBM and 12 months for AA. In group B, 6/22 patients (27%) had an objective response (4/18 GBM and 2/4 AA) and 16/22 patients (73%) did not respond. Nine patients had such an extensive tumor after one or two courses of IA ACNU that RT was cancelled. Median survival time was 8 months for GBM and 8 months for AA. Three patients (8%) had ophthalmologic toxicity on the infused side. There was no case of leukoencephalopathy.
Vega
F
F
Department of Neurology, Groupe Hospitalier Pitié-Salpètrière, Paris, France.
Davila
L
L
Chatellier
G
G
Chiras
J
J
Fauchon
F
F
Cornu
P
P
Capelle
L
L
Poisson
M
M
Delattre
J Y
JY
D000328:Adult; D000368:Aged; D001254:Astrocytoma / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D002985:Clinical Protocols; D003131:Combined Modality Therapy; D005128:Eye Diseases / Q000139:chemically induced; D005260:Female; D005909:Glioblastoma / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery; D006801:Humans; D007261:Infusions, Intra-Arterial; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy; D015376:Nimustine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D015173:Supratentorial Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery; D016019:Survival Analysis
D015376:Nimustine; D008775:Methylprednisolone