title: [Intra-arterial chemotherapy of malignant glioma after osmotic blood-brain barrier disruption].
abstract: Reversible transient osmotic blood-brain barrier disruption was used to increase drug delivery to the brain. The authors treated 10 cases of malignant gliomas with intra-arterial chemotherapy after osmotic blood-brain barrier disruption. Ten patients received intra-arterial anticancer drugs (5-FU, ACNU, IFN-beta) after intra-arterial infusion of 20% mannitol to open the blood-brain barrier at the tumor site. Clinical responses in 9 evaluable cases were 1 Complete Response, 3 Partial Responses, 5 No Change and no Progressive Disease in CT examination. Response rate was 44.4% (4/9). The most untoward effect of this method was myelosuppression. Platelet and leukocyte count diminished below 20,000 and 2,000, respectively in 3 cases, and 2 out of these 3 cases died of severe infection. The other complications were eye pain during mannitol infusion in all cases, when the selective catheterization of the internal carotid artery failed to pass the origin of the ophthalmic artery. Decreased activity was seen in 70%, nausea and vomiting in 50%, swelling of external decompression area in 33%, increased neurological deficit in 20%, but all these side effects were transient. This method was considered an effective treatment for malignant gliomas.
authors.affiliation: Dept. of Surgical Neurology, School of Medicine, Yamagata University.
authors.forename: K
authors.initials: K
authors.lastname: Yamada
authors.forename: H
authors.initials: H
authors.lastname: Takahama
authors.forename: O
authors.initials: O
authors.lastname: Nakai
authors.forename: T
authors.initials: T
authors.lastname: Takanashi
authors.forename: T
authors.initials: T
authors.lastname: Hosoya
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D001812:Blood-Brain Barrier / Q000187:drug effects*; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000378:metabolism; D005069:Evaluation Studies as Topic; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects; D005910:Glioma / Q000188:drug therapy* / Q000378:metabolism; D006801:Humans; D007261:Infusions, Intra-Arterial; D007370:Interferon Type I / Q000008:administration & dosage / Q000009:adverse effects; D007970:Leukopenia / Q000139:chemically induced; D008297:Male; D008353:Mannitol / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D015376:Nimustine / Q000008:administration & dosage / Q000009:adverse effects; D009997:Osmotic Pressure; D012074:Remission Induction; D013921:Thrombocytopenia / Q000139:chemically induced
chemical_list: D007370:Interferon Type I; D015376:Nimustine; D008353:Mannitol; D005472:Fluorouracil