title: The influence of carmustine wafer implantation on tumor bed cysts and peritumoral brain edema.
abstract: The development of perifocal edema and tumor bed cyst has been reported after implantation of biodegradable carmustine wafers for the treatment of malignant gliomas. We retrospectively evaluated these changes in a series of patients; 19 consecutive patients with malignant glioma who received carmustine wafer implantation at our hospital from January 2013 through July 2013, and 28 patients who underwent surgery prior to our institution's initiation of carmustine wafer implantation, as historical controls. The volume of the tumor bed cyst and perifocal edema was calculated on MRI acquired at four time points: ⩽72hours after surgery for baseline, and at 1-4, 5-8, and 9-12weeks after surgery. The volume of the tumor bed cyst in the wafer group increased significantly relative to the control group at all time points (p=0.04). Opening of the ventricle was inversely correlated with enlargement of the tumor bed cyst in the wafer group (p=0.04). The change in the volume of perifocal edema in the wafer group was not significantly different (p=0.48), but exhibited a considerable increase in patients with anaplastic oligodendroglioma relative to glioblastoma patients in the wafer group (p=0.01). We demonstrated significant enlargement of the tumor bed cyst volume after carmustine wafer implantation, as well as the development of marked perifocal edema in patients with anaplastic oligodendroglioma.
authors.affiliation: Division of Neurological Surgery, Chiba Cancer Centre, 666-2 Nitonacho, Chuo-ku, Chiba City, Chiba 260-8717, Japan. Electronic address: yhasegawa@chiba-cc.jp.
authors.forename: Yuzo
authors.initials: Y
authors.lastname: Hasegawa
authors.affiliation: Division of Neurological Surgery, Chiba Cancer Centre, 666-2 Nitonacho, Chuo-ku, Chiba City, Chiba 260-8717, Japan.
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Iuchi
authors.affiliation: Division of Neurological Surgery, Chiba Cancer Centre, 666-2 Nitonacho, Chuo-ku, Chiba City, Chiba 260-8717, Japan.
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Sakaida
authors.affiliation: Division of Chemotherapy and Cancer Diagnosis, Chiba Cancer Centre, Chuo-ku, Chiba City, Chiba 260-8717, Japan.
authors.forename: Sana
authors.initials: S
authors.lastname: Yokoi
authors.affiliation: Division of Neurological Surgery, Chiba Cancer Centre, 666-2 Nitonacho, Chuo-ku, Chiba City, Chiba 260-8717, Japan.
authors.forename: Koichiro
authors.initials: K
authors.lastname: Kawasaki
mesh_terms: D000368:Aged; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage / Q000009:adverse effects*; D001929:Brain Edema / Q000139:chemically induced*; D001932:Brain Neoplasms / Q000188:drug therapy*; D002330:Carmustine / Q000008:administration & dosage / Q000009:adverse effects*; D003560:Cysts / Q000139:chemically induced*; D005260:Female; D005910:Glioma / Q000188:drug therapy*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D018906:Antineoplastic Agents, Alkylating; D002330:Carmustine
keywords: Brain edema; Carmustine wafer; Cysts; Glioma; MRI