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Leukoencephalopathy associated with intra-arterial ACNU in patients with gliomas

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Summary

Thirty cases of gliomas treated by surgery, radiotherapy and intra-arterial (IA) ACNU were reviewed with a focus on the late side-effect known as leukoencephalopathy. All cases were classified into three groups; remission (10 cases), regrowth (15 cases) and leukoencephalopathy (5 cases) from their outcome. The average total doses of IA ACNU were 49.8 mg/sqm body surface area in the remission group, 157.3 mg/sqm in the regrowth group and 203.1 mg/sqm in the leukoencephalopathy group. There were significant differences in the total IA ACNU doses between the remission group and both regrowth and leukoencephalopathy groups, while no significant differences were noticed in the dose of radiation given. There was a correlation between the total dose of IA ACNU and the occurrence of leukoencephalopathy. An autopsy of a typical case of leukoencephalopathy revealed various degrees of myelin breakdown and thickening of arterial walls, which probably manifested progressive dementia accompanied by urinary incontinence and gait disturbance.

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Authors and Affiliations

  1. Department of Neurological Surgery, Institute of Clinical Medicine, University of Tsukuba, Tsukuba, 305, Ibaraki, Japan

    Koji Tsuboi, Yoshihiko Yoshii, Akio Hyodo & Tadao Nose

  2. Department of Neuropathology, Tokyo Neuro-Science Institute, Fuchu, 183, Tokyo, Japan

    Kuniyasu Takada

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  1. Koji Tsuboi
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  2. Yoshihiko Yoshii
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  3. Akio Hyodo
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  4. Kuniyasu Takada
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  5. Tadao Nose
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Tsuboi, K., Yoshii, Y., Hyodo, A. et al. Leukoencephalopathy associated with intra-arterial ACNU in patients with gliomas. J Neuro-Oncol 23, 223–231 (1995). https://doi.org/10.1007/BF01059953

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