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The
role of interstitial BCNU chemotherapy in the treatment of malignant glioma
Engelhard HH
Department of Neurosurgery, The University of Illinois at
Chicago, 60612, USA.
Background. Use of interstitial BCNU wafers in the treatment of malignant
glioma is currently a controversial topic among neurosurgeons.
Initial clinical studies indicated implantation of BCNU wafers into the
postoperative tumor bed to be an acceptably safe, partially effective treatment
for glioblastoma multiforme.
Yet a more recent study has put the efficacy of this treatment in doubt, and
there are potential complications associated with BCNU wafer use.
Objective.
This article presents a review of the information presently available on BCNU
wafers-both pro and con-to aid in the clinical decision-making process.
The article focuses on studies of clinical efficacy (for initial use as well as
in the setting of recurrent tumor), complications associated with BCNU wafers,
and the experimental data, particularly related to BCNU penetration into the
brain.
Results.
Animal studies and computer simulations have shown that the depth of penetration
of BCNU from wafers is limited.
Yet in actual clinical use, the interstitial pressure within the wafer-laden
tumor bed might be higher, convective flow greater, and delivery of BCNU to the
brain more significant than predicted.
Conclusion.
Based on current information, use of interstitial BCNU wafers continues to be an
option for treating malignant glioma.
Additional clinical studies of BCNU wafers are currently underway.
PMID:
10874145 [PubMed - indexed for MEDLINE]
Source: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10874145&dopt=Abstract |
