Skip to main content
Log in

Combined intra-arterial chemotherapy followed by radiation in astrocytomas

  • Clinical Study
  • Published:
Journal of Neuro-Oncology Aims and scope Submit manuscript

Summary

Seventy-five patients harboring astrocytomas received 4 cycles of infra-ophtalmic carotid injections of BCNU, combined with vincristine intravenously and procarbazine orally. All of the patients thereafter, received radiation therapy. The five year survival was 73% for all patients. The age of the patients had no significant impact on survival.

The treatment results were compared with the results of 57 patients with astrocytomas who were treated with surgery followed by radiation in the same period. These 57 patients had a 5 year survival of 45% with a five year survival in patients >- 40 years and patients < 40 years of 70% and 22%, respectively (p < 0.05).

In multivariate survival analysis of the BCNU group and radiation group together, treatment group and corticosteroid dependency were the only prognostic factors. No leukoencephalopathy was seen during the treatment or in the follow-up of the patients.

We conclude that pre-radiation infra-arterial chemotherapy can be given without significant morbidity and produces an improvement in survival in patients older than 40 years.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Russell DS, Rubinstein LJ: Pathology of tumours of nervous system. 3rd edition. Edward Arnold, London, 1971

    Google Scholar 

  2. Schoenberg BS: Epidemiology of primary nervous system neoplasms. In: Schoenberg BS (ed) Advances in neurology, Vol 19, Raven Press, New York 475–495, 1978

    Google Scholar 

  3. Marsa GW, Goffinet DR, Rubinstein LJ, Bagshaw MA: Megavoltage irradiation in the treatment of gliomas of the brain and spinal cord. Cancer 36: 1681–1689, 1975

    Google Scholar 

  4. Scanlon PW, Taylor WF: Radiotherapy of intracranial astrocytomas: analysis of 417 cases treated from 1960 through 1969. Neurosurg 5: 301–308, 1979

    Google Scholar 

  5. Clinton KL: Low grade astrocytomas: treatment results and prognostic variables. Int J Radiat Oncol Biol Phys 15: 837–841,1988

    Google Scholar 

  6. Laws ER, Taylor WF, Chifton MB, Okazaki H: Neurosurgical management of low-grade astrocytoma of the cerebral hemispheres. J Neurosurg 61: 665–673, 1984

    Google Scholar 

  7. Leibel SA, Sheline GE, Wara WM et al.: The role of radiation therapy in the treatment of astrocytomas. Cancer 1975;35:1551–1557

    Google Scholar 

  8. Lindgren M: Roentgen treatment of gliomata. Acta Radiol 40: 325–334, 1953. Schulz MD, Wang CC, Zinninger GF et al.: Radiotherapy of intracranial neoplasms. Prog Neurol Surg 2: 318–370, 1968

    Google Scholar 

  9. Svien H, Mabon R, Kernohan JW: Astrocytomas. Mayo Clin Proc 25: 54–64, 1949

    Google Scholar 

  10. Leibel SA, Sheline GE: Radiation therapy for neoplasms of the brain. J Neurosurg 66: 1–22, 1987

    Google Scholar 

  11. Morantz RA: Radiation therapy in the treatment of cerebral astrocytoma. Neurosurg 20: 975–982, 1987

    Google Scholar 

  12. Bloom HJG: Intracranial tumors: Response and resistance to therapeutic endeavors. 1970–1980. Int J Radiat Oncol Biol Phys 8: 1083–1113, 1982

    Google Scholar 

  13. Fazekas JT: Treatment of Grades I and 11 brain astrocytomas. The role of radiotherapy. Int J Radiat Oncol Biol Phys 2:661–666,1977

    Google Scholar 

  14. Soffietti R, Adriano C: Prognostic factors in astrocytomas. Neurosurg 24 (5): 686–692, 1989

    Google Scholar 

  15. Sheline GE: Radiation therapy of brain tumors. Cancer 39: 873–881,1977

    CAS  PubMed  Google Scholar 

  16. Avellanosa AM, West CR, Barua NR: Treatment of malignant CNS glioma by intra-arterial BCNU infusion. Proc Am Assoc Cancer Res 20: 384, 1979

    Google Scholar 

  17. Greenbert HS, Ensminger WD, Chandler WF: Intra-arterial BCNU chemotherapy for the treatment of malignant gliomas of the central nervous system. J Neurosurg 61: 423–429,1984

    Google Scholar 

  18. West CR, Avellanosa AM, Barua NR: Intra-arterial 1,3bis(2-chloroethyl)-1-nitrosourea (BCNU) and systemic chemotherapy for malignant gliomas: A follow-up study. Neurosurg 13: 420–426, 1983

    Google Scholar 

  19. Bigner DD, Bullard D, Schold C, Preissig SH, Wikstrand CJ: Cellular heterogeneity and diversity as a basis for therapeutic resistance of human gliomas. In: Paoletti P, Walker MD, Butti G, Knerich R (eds) Multidisciplinary aspects of brain tumor therapy, Elsevier/North-Holland, Amsterdam 329–335,1979

    Google Scholar 

  20. Bugdahn U: Chemosensitivity of malignant human brain tumors. J Neurol Oncol 1: 149–166, 1983

    Google Scholar 

  21. Edwards MS, Levin VA, Wilson CB: Brain tumor chemotherapy. Can Treat Rep 64: 1179–1205, 1980

    Google Scholar 

  22. Cox DR: Regression models and life-tables. JR Stat Soc B 34:187–220,1972

    Google Scholar 

  23. Cutler S, Ederer F: Maximum utilization of the life method in analyzing survival. J Chron Dis 8: 699–712, 1958

    Google Scholar 

  24. Dixon WJ, Brown MB, Engelman L (eds): BMDP Statistical Software Manual. University of California Press, Berkeley, 1988

    Google Scholar 

  25. Peto R, Pike MC, Armitage P: Design and analysis of randomized clinical trials requiring prolonged observation of each patient. Br J Cancer 35: 1–39, 1977

    CAS  PubMed  Google Scholar 

  26. Arnold DL, Shoubridge EA, Feindel W, Villemure JG: Metabolic changes in cerebral gliomas within hours of treatment with intra-arterial BCNU demonstrated by phosphorus magnetic resonance spectroscopy. Can J Neurol Sci 14: 570–575,1987

    Google Scholar 

  27. Lasker P, Ayres JW: Degradation of carmustine in aqueous media. J Pharmac Sci 66: 1073–1076, 1977

    Google Scholar 

  28. Wike-Hooley JL, Haveman J, Reinhold HS: The relevance of tumour pH to the treatment of malignant disease. Radiother Oncol 2: 343–366, 1984

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Watne, K., Hannisdal, E., Nome, O. et al. Combined intra-arterial chemotherapy followed by radiation in astrocytomas. J Neuro-Oncol 14, 73–80 (1992). https://doi.org/10.1007/BF00170947

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00170947

Key words

Navigation