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Intratumoral microinfusion of nimustine (ACNU) for recurrent glioma

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Abstract

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.

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References

  1. Yoshida J, Kajita Y, Wakabayashi T, et al (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

    Article  CAS  Google Scholar 

  2. Lieberman DM, Laske DW, Morrison PF, et al (1995) Convection-enhanced distribution of large molecules in gray matter during interstitial drug infusion. J Neurosurg 82:1021–1029

    Article  PubMed  CAS  Google Scholar 

  3. Fung LK, Ewend M, Sills A, et al (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

    PubMed  CAS  Google Scholar 

  4. Laske DW, Youle RJ, Oldfield EH (1997) Tumor regression with regional distribution of the targeted toxin TF-CRM107 in patients with malignant brain tumors. Nature Med 3:1362–1368

    Article  PubMed  CAS  Google Scholar 

  5. Hori T, Muraoka K, Saito Y, et al (1987) Influence of modes of ACNU administration on tissue and blood drug concentration in malignant brain tumor. J Neurosurg 66:372–378

    PubMed  CAS  Google Scholar 

  6. Yamashima T, Yomashita J, Shoin K (1990) Neurotoxicity of local administration of two nitrosoureas in malignant gliomas. Neurosurgery 26:794–800

    Article  PubMed  CAS  Google Scholar 

  7. Levin VA, Byrd D, Campbell J, et al (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

    PubMed  CAS  Google Scholar 

  8. Ewend MG, Sampath P, Williams JA, et al (1998) Local delivery of chemotherapy prolongs survival in experimental brain metastases from breast carcinoma. Neurosurgery 43:1185–1193

    Article  PubMed  CAS  Google Scholar 

  9. Brem H, Fung LK, Ewend M, et al (1995) Placebo-controlled trial of safety and efficacy of intraoperative controlled delivery by biodegradable polymers of chemotherapy for recurrent gliomas. Lancet 345:1008–1012

    Article  PubMed  CAS  Google Scholar 

  10. Walter KA, Tamargo RJ, Olivi A, et al (1995) Intratumoral chemotherapy. Neurosurgery 37:1128–1145

    PubMed  CAS  Google Scholar 

  11. Chen MY, Lonser RR, Moorison PF, et al (1999) Variables affecting convection-enhanced delivery to the striatum: a systematic examination of rate of infusion, cannula size, infusate concentration, and tissue-cannula sealing time. J Neurosurg 90:315–320

    Article  PubMed  CAS  Google Scholar 

  12. Kroll RA, Pagel MA, Muldoon LL, et al (1998) Improving drug delivery to intracerebral tumor and surrounding brain in a rodent model: a comparison of osmotic versus bradykinin modification of the blood-brain and/or blood-tumor barries. Neurosurgery 43:879–889

    Article  PubMed  CAS  Google Scholar 

  13. Tamargo RJ, Myseros JS, Epstein JI, et al (1993) Interstitial chemotherapy of the 9L gliosarcoma: controlled release polymers for drug delivery in the brain. Cancer Res 53:329–333

    PubMed  CAS  Google Scholar 

  14. Takakura K, Abe H, Tanaka R, et al (1986) Effects of ACNU and radiotherapy on malignant glioma. J Neurosurg 64:53–57

    PubMed  CAS  Google Scholar 

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Correspondence to Toshihiko Wakabayashi.

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Wakabayashi, T., Yoshida, J., Mizuno, M. et al. Intratumoral microinfusion of nimustine (ACNU) for recurrent glioma. Brain Tumor Pathol 18, 23–28 (2001). https://doi.org/10.1007/BF02478921

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  • DOI: https://doi.org/10.1007/BF02478921

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