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Intra-arterial chemotherapy for brain stem glioma: report of four cases

  • Interventional Neuroradiology
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Abstract

Four patients with pontine gliomas were treated with radiation and intra-arterial chemotherapy using ACNU, cisplatin, and/or carboplatin. All underwent biopsy and were histologically proven to have gliomas. Even though three were benign histologically, all appeared malignant on neuroimaging. Two patients had complete remissions; the others had partial responses; three patients died, 36, 14, and 15 months after the primary diagnosis. One patient, now in complete remission, has been alive for 24 months. There was no neurotoxicity except for transient nausea and vomiting. Intra-arterial chemotherapy is effective against brain stem gliomas, producing remission with minimum side effects.

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References

  1. Committee of the Brain Tumor Registry in Japan (1897) A statistical study of brain tumors in Japan: general features. Jpn J Clin Oncol 17:19–28

    Google Scholar 

  2. Atac MS, Blaauw G (1979) Radiotherapy in brain stem gliomas in children. Clin Neurol Neurosurg 81:281–290

    Google Scholar 

  3. Eifel PJ, Cassady JR, Belli JA (1987) Radiation therapy of tumors of the brainstem and midbrain in children: experience of the Joint Center for Radiation Therapy and Children's Hospital Medical Center (1971–1981). Int J Radiat Oncol Biol Phys 13:847–852

    Google Scholar 

  4. Freeman R, Suissa S (1986) Brain stem tumors in children: results of a survey of 62 patients treated with radiotherapy. Int J Radiat Oncol Biol Phys 12:1823–1828

    Google Scholar 

  5. Fulton DS, Levin VA, Wara WM, Edwards MS, Wilson CB (1981) Chemotherapy of pediatric brain-stem tumors. J Neurosurg 54:721–725

    Google Scholar 

  6. Jenkin RDT, Boesel C, Ertel I, Evans A, Hitlle R, Ortega J, Sposto R, Wara WM, Wilson GB, Anderson J, Leikin S, Hammond GD (1987) Brain-stem tumors in childhood: a prospective randomized trial of irradiation with and without adjuvant CCNU, VCR, and prednisone. J Neurosurg 66:227–233

    Google Scholar 

  7. Kim TH, Chin HW, Pollan S, Hazel JH, Webster JH (1980) Radiotherapy of primary brain stem tumors. Int J Radiat Oncol Biol Phys 6:51–57

    Google Scholar 

  8. Langmoen IA, Lundar T, Storm-Mathisen I, Lie SO, Hovind KH (1991) Management of paediatric pontine gliomas. Child's Nerv Syst 7:13–15

    Google Scholar 

  9. Lee F (1975) Radiation of infratentorial and supratentorial brain-stem tumors. J Neurosurg 43:65–68

    Google Scholar 

  10. Levin VA, Edwards MS, Wara WM, Allen J, Ortega J, Vestnys P (1984) 5-Fluorouracil and 1-(2-chloro-ethyl)-3-cyclohexyl-1-nitrosourea (CCNU) followed by hydroxyurea, misonidazole, and irradiation for brain stem gliomas: A pilot study of the Brain Tumor Research Center and Children's Cancer Group. Neurosurgery 14:679–681

    Google Scholar 

  11. Tanaka R, Murakami N, Suzuki Y, Takeda N, Arai H, Konno K, Tanimura K (1984) Radiotherapy using bleomycin, ACNU, and vincristine for malignant brain tumors. Neurol Med Chir 24:557–563 (in Japanese)

    Google Scholar 

  12. Allen JC, Walker R, Luks E, Jennings M, Barfoot S, Tan C (1987) Carboplatin and recurrent childhood brain tumor. J Clin Oncol 5: 459–463

    Google Scholar 

  13. Kitoh A, Yoshida J, Kageyama N (1987) Controlled multimodality treatment of brain stem gliomas. No-shinkei 15:797–803 (in Japanese)

    Google Scholar 

  14. Pomplii A, Riccio A, Jandolo B, Fontana M (1980) CCNU chemotherapy in adult patients with tumors of the basal ganglia and brain stem. J Neurosurg 53:361–363

    Google Scholar 

  15. Rosen G, Ghavimi F, Vanucci R, Deck M, Tan C, Murphy ML (1974) Pontine glioma: High dose methotrexate and leucovorin rescue. JAMA 230:1149–1152

    Google Scholar 

  16. Rosenstock JG, Evans AE, Schut L (1976) Response to vincristine of recurrent brain tumors in children. J Neurosurg 45:135–140

    Google Scholar 

  17. Walker RW, Allen JC (1988) Cisplatin in the treamtment of recurrent childhood primary brain tumors. J Clin Oncol 6:62–66

    Google Scholar 

  18. Zeltzer PM, Epport K, Nelson MD Jr, Huff K, Gaynon P (1991) Prolonged response to carboplatin in an infant with brain stem glioma. Cancer 67:43–47

    Google Scholar 

  19. Hori T, Muraoka K, Saito Y, Sasahara K, Inagaki H, Inoue Y, Adachi S, Anno Y (1987) Influence of modes of ACNU administration on tissue and blood drug concentration in malignant brain tumors. J Neurosurg 66:372–378

    Google Scholar 

  20. Levin VA, Kabra PM, Freeman-Dove MA (1978) Pharmacokinetics of intracarotid artery14C-BCNU in the squirrel monkey. J Neurosurg 48:587–593

    Google Scholar 

  21. Stewart DJ, Benjamin RS, Luna M, Feun L, Caprioli R, Seifert W, Loo TL (1982) Human tissue distribution of platinum after cis-diamminedichloroplatinum. Cancer Chemother Pharmacol 10:51–54

    Google Scholar 

  22. Stewart DJ, Leavens M, Maor M, Feun L, Luna M, Bonura J, Aprioli R, Loo TL, Benjamin RS (1982) Human central nervous system distribution of cis-diamminedichloroplatinum and use as a radiosensitizer in malignant brain tumors. Cancer Res 42: 2474–2479

    Google Scholar 

  23. Greenberg HS, Ensminger WD, Chandler WF, Layton PB, Junck L, Knake J, Vine AK (1984) Intra-arterial BCNU chemotherapy for treatment of malignant gliomas of the central nervous system. J Neurosurg 61:423–429

    Google Scholar 

  24. Hochberg FH, Pruitt AA, Beck DO, DeBrun G, Davis K (1985) The rationale and methodology for intra-arterial chemotherapy with BCNU as treatment for glioblastoma. J Neurosurg 63:876–880

    Google Scholar 

  25. Seiki Y, Shibata I, Terao H, Kudo M, Noguchi T (1991) Pharmacokinetic study of selective continuous internal carotid CDDP infusion in malignant brain tumors. Neurol Med Chir 31:695–701

    Google Scholar 

  26. Mahaley MS, Whaley RA, Blue M, Bertsch L (1986) Central neurotoxicity following intracarotid BCNU chemotherapy for malignant gliomas. J Neuro-oncol 3:297–314

    Google Scholar 

  27. Stewart DJ, Grahovac Z, Benoit B, Addison D, Richard MT, Dennery J, Hugenholtz H, Russell N, Peterson E, Maroun JA, Vandenberg T, Hopkins HS (1984) Intracarotid chemotherapy with a combination of 1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU), cis-diamminedichloroplatinum (cisplatin) and 4′-O-dimethyl-1-O-(4,6-O-2-thenylidene-D-glucoopyranosyl) epipodophyllotoxin (VM-26) in the treamtent of primary and metastatic brain tumors. Neurosurgery 15:828–833

    Google Scholar 

  28. Berger MS, Edwards MSB, LaMasters D, Davis RL, Wilson CB (1983) Pediatric brain stem tumors: radiographic, pathological, and clinical correlations. Neurosurgery 12:298–302

    Google Scholar 

  29. Epstein F, McCleary EL (1986) Intrinsic brainstem tumors of childhood: surgical indications. J Neurosurg 64:11–15

    Google Scholar 

  30. Tomita T, McLone DG, Naidich TP (1984) Brain stem gliomas in childhood: rational approach and treatment. J Neuro-oncol 2: 117–122

    Google Scholar 

  31. Hara M, Takeuchi K (1977) A temporaly study of survival of patients with pontine gliomas. J Neurol 216:189–196

    Google Scholar 

  32. Albright AL, Guthkelch AN, Packer RJ, Price RA, Rourke LB (1986) Prognostic factors in pediatric brain-stem gliomas. J Neurosurg 65:751–755

    Google Scholar 

  33. Littman P, Jarrett P, Bilanuik LT, Rorke LB, Zimmerman RA, Bruce DA, Carabell SC, Schut L (1980) Pediatric brain stem gliomas. Cancer 45:2787–2792

    Google Scholar 

  34. Nishio S, Fukui M, Tateishi J (1988) Brain stem gliomas: a clinicopathological analysis of 23 histologically proven cases. J Neurooncol 6:245–250

    Google Scholar 

  35. Stroink AR, Hoffman HJ, Hendrick EB, Humpreys RP (1986) Diagnosis and management of pediatric brain-stem gliomas. J Neursurg 65:745–750

    Google Scholar 

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Authors and Affiliations

  1. Department of Radiology, Kagawa Medical School, Kagawa, Japan

    M. Ohkawa

  2. Department of Neurological Surgery, Kagawa Medical School, 1750-1 Ikenobe, Miki-cho, Kita-gun, 761-07, Kagawa, Japan

    T. Fujiwara, T. Ogawa, K. Irie, T. Tsuchida & S. Nagao

Authors
  1. T. Fujiwara
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  2. T. Ogawa
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  3. K. Irie
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  4. T. Tsuchida
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  5. S. Nagao
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  6. M. Ohkawa
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Fujiwara, T., Ogawa, T., Irie, K. et al. Intra-arterial chemotherapy for brain stem glioma: report of four cases. Neuroradiology 36, 74–79 (1994). https://doi.org/10.1007/BF00599203

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