Mahaley Ms

Central neurotoxicity following intracarotid BCNU chemotherapy for malignant gliomas

SummaryCentral neurotoxicity is reported in 5 of 16 patients with recently diagnosed anaplastic gliomas, who received intra-arterial BCNU (200 mg/M2/course) and also 2 in a series of 26 patients with recurrent gliomas similarly treated. Neurotoxicity was usually delayed, commencing several weeks following the second or third course. CT scans during central neurotoxicity represented 1 or more of 3 patterns: no change; increased low density area(s); and/or ipsilateral gyral enhancement and punctate calcification in the middle cerebral artery territory. In one clinicopathological correlation, coagulative necrosis of the white matter was observed, identical histologically to those changes recognized as delayed vascular events following radiotherapy. Cautious exploration of the various clinical factors that may contribute to this toxicity seems appropriate, as exploration of the potential benefits of regional chemotherapeutic infusions is undertaken.

Immunologic Considerations of Patients with Brain Tumors

Continued interest in the immunologic considerations of patients with malignant gliomas stems from the frustration that clinicians face in current concepts of management coupled with the attractiveness of the hypothetical, selective destruction of malignant cells by elements of the immune system. Our frustration with current therapies is exemplified by the fact that the most effective combinations of surgery, radiotherapy, and chemotherapy for malignant gliomas only increases the median survival time from 17 weeks for patients untreated postoperatively to a little over a year for optimally treated patients [1]. The attractiveness of mobilizing the immune system to control neoplasia has undoubtedly been promoted by the recognized cellular immune responses that all too successfully result in transplantation rejections together with the humoral (antibody) immune mechanisms responsible for specific and timely neutralization and destruction of microbial invaders.

Effect of methylprednisolone on radiotherapy of F344 rats with avian sarcoma virus induced gliomas

We have examined the impact of methylprednisolone acetate (MPA) on survival of F344 rats that were bearing avian sarcoma virus (ASV)-induced gliomas and that were treated optimally with radiotherapy. Toxicity of MPA (dose range of 0.2–5.0 mg/kg × 7 over 3 weeks) was first established in non-tumor bearing rats as assessed by their relative failure to gain weight. Doses of 2.0 or 5.0 mg/kg x 7 caused animals to be 21.8 or 43.9%, respectively, underweight compared with vehicle controls. In rats bearing ASV induced gliomas, treatment with 3 000 cGY (nine fractions over a 3-week period) alone or with 0.2 or 1.0 mg MPA/kg (× 6 during the 3-week radiotherapy course) produced a significantly prolonged survival compared with that of untreated, tumor bearing rats. However, MPA did not enhance survival when given concurrently with radiotherapy; indeed, at the higher of these two doses, median survival of tumor-bearers was slightly less than with radiotherapy alone. This trend towards interference with the beneficial effects of radiotherapy was more pronounced with the highest dose of MPA studied, 5.0 mg/kg body weight × 6. These animals had a median survival time that was significantly less than that of tumor-bearers receiving radiotherapy alone, but not significantly different from untreated rats with gliomas. The possible significance of these observations is discussed.

Treatment of autochthonous rat brain tumors with steroid plus heparin: a brief report.

Treatment of rats bearing intracranial gliomas induced by the avian sarcoma virus with heparin plus steroid has failed to effectively extend survival time.

Immunotherapy of patients with brain tumors — current prospective

This presentation reviews the experience with immunotherapy of anaplastic glioms and reports in more detail our own recent findings with the use of interferon in patients with recurrent gliomas.