Intratumoral microinfusion of nimustine (ACNU) for recurrent glioma.

被引:9
作者
Wakabayashi T. [1 ]
Yoshida J. [1 ]
Mizuno M. [1 ]
Kajita Y. [1 ]
机构
[1] Department of Neurosurgery, Nagoya University School of Medicine
关键词
Glioma; Chemotherapy; Local infusion; Nimustine (ACNU);
D O I
10.1007/BF02478921
中图分类号
学科分类号
摘要
We investigated stereotactic intratumoral microinfusion of nimustine (ACNU) in recurrent brain tumors. Eligibility required histologic confirmation of glioma recurrence despite standard radiotherapy and chemotherapy as well as enhancement of the recurrence with gadolinium on magnetic resonance imaging (MRI). A total intratumoral dose of 10 mg of ACNU was administered continuously with a microinfusion pump over an average of 13h. Fifteen infusions were given in nine patients. All patients completed the treatment safely. On MRI, necrotic changes surrounded the infusion area in all patients, and tumor progression was inhibited or performance score was improved in seven of nine patients. No symptomatic systemic toxicity was evident, although one patient developed permanent left oculomotor palsy locally after treatment of a left medial temporal tumor. It is concluded that direct microinfusion of ACNU into recurrent gliomas can induce tumor necrosis and inhibit tumor growth.
引用
收藏
页码:23 / 28
页数:5
相关论文
共 42 条
[1]  
Yoshida J(1994)Long-term follow-up results of 175 patients with malignant glioma: importance of radical tumour resection and postoperative adjuvant therapy with interferon, ACNU and radiation Acta Neurochir (Wien) 127 55-59
[2]  
Kajita Y(1995)Convection-enhanced distribution of large molecules in gray matter during interstitial drug infusion J Neurosurg 82 1021-1029
[3]  
Wakabayashi T(1998)Pharmacokinetics of interstitial delivery of carmustine, 4-hydroperoxycyclophosphamide and paclitaxel from a biodegradable polymer implant in the monkey brain Cancer Res 58 672-684
[4]  
Lieberman DM(1997)Tumor regression with regional distribution of the targeted toxin TF-CRM107 in patients with malignant brain tumors Nature Med 3 1362-1368
[5]  
Laske DW(1987)Influence of modes of ACNU administration on tissue and blood drug concentration in malignant brain tumor J Neurosurg 66 372-378
[6]  
Morrison PF(1990)Neurotoxicity of local administration of two nitrosoureas in malignant gliomas Neurosurgery 26 794-800
[7]  
Fung LK(1985)Central nervous system toxicity and cerebrospinal fluid pharmacokinetics of intraventricular 3-[(4-amino-2-methyl-5-pyrimidinyl)ethyl]-1(2-chloroethyl)-1-nitrosourea and other nitrosourea in beagles Cancer Res 45 3803-3809
[8]  
Ewend M(1998)Local delivery of chemotherapy prolongs survival in experimental brain metastases from breast carcinoma Neurosurgery 43 1185-1193
[9]  
Sills A(1995)Placebo-controlled trial of safety and efficacy of intraoperative controlled delivery by biodegradable polymers of chemotherapy for recurrent gliomas Lancet 345 1008-1012
[10]  
Laske DW(1995)Intratumoral chemotherapy Neurosurgery 37 1128-1145