title: Clinical toxicity of combined modality treatment with nitrosourea derivatives for central nervous system tumors.
abstract: Two nitrosourea compounds--1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU) and 1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea (CCNU)--have been used in the treatment of primary and metastatic brain tumors after operation and/or radiotherapy. Hematological and nonhematological toxicity were recorded in 272 patients treated between May 1973 and June 1978. BCNU was given to 135 patients (80 mg/m2 i.v. daily for 3 days) and CCNU was given to 137 patients (130 mg/m2 orally, single dose) every 8 weeks until progression of the primary disease process or for a total of 12 cycles. Radiation therapy (5500 +/- 500 rads in 6 to 7 weeks) was carried out after the first course of chemotherapy. BCNU and CCNU induced the same hematological and clinical toxicity. The bone marrow toxicity seemed to be dose-related, delayed, and cumulative. One case of acute nonlymphoblastic leukemia arising 2 months after the end of CCNU therapy is reported.
mesh_terms: D001855:Bone Marrow Diseases / Q000139:chemically induced*; D001932:Brain Neoplasms / Q000556:secondary / Q000628:therapy; D002330:Carmustine / Q000009:adverse effects*; D005767:Gastrointestinal Diseases / Q000139:chemically induced*; D005909:Glioblastoma / Q000628:therapy; D005910:Glioma / Q000628:therapy; D006402:Hematologic Diseases / Q000139:chemically induced*; D006801:Humans; D007938:Leukemia / Q000139:chemically induced*; D007970:Leukopenia / Q000139:chemically induced; D008130:Lomustine / Q000009:adverse effects*; D008577:Meningeal Neoplasms / Q000628:therapy; D009607:Nitrosourea Compounds / Q000009:adverse effects*; D012509:Sarcoma / Q000628:therapy; D013921:Thrombocytopenia / Q000139:chemically induced
chemical_list: D009607:Nitrosourea Compounds; D008130:Lomustine; D002330:Carmustine