title: Growth pattern of tumor recurrence following bis-chloroethylnitrosourea (BCNU) wafer implantation in malignant glioma.
abstract: Bis-chloroethylnitrosourea (BCNU; Gliadel, Eisai, Tokyo, Japan) is the only therapeutic agent for local chemotherapy of malignant gliomas approved by the US Food and Drug Administration and the European Medicines Agency. In a small patient cohort, it has previously been shown that glioblastomas recur locally despite treatment with BCNU. This raises concern about local treatment with BCNU as a stand-alone measure. The goal of this study was to analyze the growth pattern of tumor recurrence in a larger patient group: 41 patients were included in this study. Tumor recurrences were morphologically categorized as: local, diffuse, distant or multilocular. Thirty-three of the tumors (80%) that recurred were local or diffuse. These results show that BCNU implantation does not provide lasting local tumor control. Our data support the need to incorporate BCNU in to multimodal therapy schemes. The improved survival rates of patients who receive concomitant local and systemic adjuvant treatment support using local therapy to bridge the therapy-free interval of the initial postoperative phase.
authors: Department of Neurosurgery, Universitätsklinikum Schleswig-Holstein Campus, Kiel, Germany. doerner@medbaltic.de
authors: Lutz
authors: L
authors: Dörner
authors: Ahmad
authors: A
authors: Mustafa
authors: Axel
authors: A
authors: Rohr
authors: H Maximilian
authors: HM
authors: Mehdorn
authors: Arya
authors: A
authors: Nabavi
mesh_terms: D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage*; D001932:Brain Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology*; D002330:Carmustine / Q000008:administration & dosage*; D005260:Female; D005910:Glioma / Q000188:drug therapy / Q000401:mortality / Q000473:pathology*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology*
chemical_list: D018906:Antineoplastic Agents, Alkylating; D002330:Carmustine