title: [Risk Factors for Adverse Events after Implantation of BCNU Wafers in High-grade Gliomas].
abstract: BACKGROUND
  In Japan, patients with malignant glioma have been treated with BCNU wafers (Gliadel®) since January 2013. Several adverse events(AEs)associated with implantation of BCNU wafers, including cerebral edema or cyst formation, are recognized. Here, we report a retrospective review of the experience with implantation of BCNU wafers in our institutions and our findings regarding the risk factors for the AEs.
  
  
  METHODS
  We reviewed the records of patients with malignant glioma who were implanted with BCNU wafers between April 2013 and September 2014. Their AEs were examined clinically and radiologically and evaluated according to Common Terminology Criteria for Adverse Events (CTCAE) grading. For investigating the association between risk factors and incidence of AEs, histological diagnosis, extent of resection, and period of BCNU wafers implantation surgery were selected as possible risk factors.
  
  
  RESULTS
  Twenty-one patients were included in this investigation. There were no associations among incidence of AEs and histological diagnosis or extent of tumor resection. However, regarding the period of BCNU wafers implantation, additional resection for newly diagnosed tumors and resection for recurrent tumors tended to increase the rate and severity of AEs, especially cerebral edema, compared to primary resection.
  
  
  CONCLUSIONS
  In cases of BCNU wafers implantation, the incidence and degree of AEs might increase if additional resection for newly diagnosed tumors or resection for recurrent tumors is performed. Our investigation revealed that AEs associated with implantation of BCNU wafers tend to occur in the repeated glioma surgery.
authors.affiliation: Department of Neurosurgery, Graduate School of Medicine, Hokkaido University.
authors.forename: Michiharu
authors.initials: M
authors.lastname: Yoshida
authors.forename: Shigeru
authors.initials: S
authors.lastname: Yamaguchi
authors.forename: Yukitomo
authors.initials: Y
authors.lastname: Ishi
authors.forename: Shogo
authors.initials: S
authors.lastname: Endo
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Motegi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kobayashi
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Asaoka
authors.forename: Yuuta
authors.initials: Y
authors.lastname: Kamoshima
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Terasaka
authors.forename: Kiyohiro
authors.initials: K
authors.lastname: Houkin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D002330:Carmustine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003652:Decanoic Acids / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D018450:Disease Progression; D005260:Female; D005910:Glioma / Q000188:drug therapy* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D011091:Polyesters / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D018906:Antineoplastic Agents, Alkylating; D003652:Decanoic Acids; D011091:Polyesters; C574855:carmustine, poliferprosan 20 drug combination; D002330:Carmustine