Journal of Neuro-Oncology

, Volume 35, Issue 2, pp 121–132

Intra-arterial carboplatin chemotherapy for brain tumors: A dose escalation study based on cerebral blood flow

  • Timothy F. Cloughesy
  • Y. Pierre Gobin
  • Keith L. Black
  • Fernando Viñuela
  • Foster Taft
  • Behdad Kadkhoda
  • Fairooz Kabbinavar
Article

DOI: 10.1023/A:1005856002264

Cite this article as:
Cloughesy, T.F., Gobin, Y.P., Black, K.L. et al. J Neurooncol (1997) 35: 121. doi:10.1023/A:1005856002264

Abstract

Purpose. To perform an intra-arterial dose escalation studyof carboplatin based on hemispheric blood-flow estimation inpatients with recurrent malignant glioma. The primary purposewas to determine the maximally tolerated intra-arterial dose.Methods and patients. Methods included: 1) selective intra-arterialdelivery performed with modern microcatheters, 2) pulsatile infusion,and 3) dosage based on local cerebral blood-flowestimation (middle cerebral artery 60%, anterior cerebral artery20%, posterior cerebral artery 15%, and anterior choroidalartery 5% of the hemispheric blood-flow). The deliverieswere performed above the ophthalmic artery in theanterior circulation, or above the anterior inferior cerebellararteries in the posterior circulation. The doses wereescalated from 200 mg/hemisphere at 50 mg increments.Twenty-one patients were studied (14 with glioblastoma multiforme,five anaplastic astrocytoma, one aggressive low-grade glioma, onemetastasis). Patients had recurrent glioma limited to onehemisphere and Karnofsky score of 50 or greater.Concomitant therapies were allowed. Results. Carboplatin was escalatedto a dose of 1400 mg/hemisphere. One patienthad a permanent neuromotor decline. The predominant toxicitywas hematopoietic. The median time to tumor progressionwas 22 weeks, median survival 39 weeks, andthe response rate 70% (50% SD and 20%PR) of 19 patients. Conclusions. Hemispheric blood-flow estimationallowed us to escalate the dose of intra-arterialcarboplatin to twice what was previously considered safe.Responses compared favorably to previous studies. Further studiesare needed to determine if this method willprovide improved and durable responses.

intraarterial carboplatin blood flow glioma brain tumor 

Copyright information

© Kluwer Academic Publishers 1997

Authors and Affiliations

  • Timothy F. Cloughesy
    • 1
    • 2
  • Y. Pierre Gobin
    • 3
  • Keith L. Black
    • 1
    • 2
    • 4
  • Fernando Viñuela
    • 3
  • Foster Taft
    • 2
  • Behdad Kadkhoda
    • 2
  • Fairooz Kabbinavar
    • 1
    • 5
  1. 1.Jonsson Comprehensive Cancer CenterUSA
  2. 2.Departments of NeurologyUSA
  3. 3.RadiologyUSA
  4. 4.SurgeryUSA
  5. 5.MedicineUCLA School of MedicineLos AngelesUSA

Personalised recommendations