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The Intraarterial Route of Drug Delivery in the Chemotherapy of Malignant Brain Tumours

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Advances and Technical Standards in Neurosurgery

Part of the book series: Advances and Technical Standards in Neurosurgery ((NEUROSURGERY,volume 16))

Summary

This review is based on literature data and own experiences in 79 patients with malignant brain tumours using intraarterial delivery of cytostatic agents as adjuvant therapy. A survey is given of the pharmacological rationale of this therapeutic approach, of the drugs which have been used and of the related experimental and clinical experiences. Advantages and limitations are discussed and clinical conclusion drawn.

Experience so far suggests that in anaplastic astrocytomas and oligodendrogliomas intraarterial ACNU might be as effective as intravenous BCNU against the tumours but causes less systemic side-effects.

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Abbreviations

ACNU:

3-(4-amino-2-methyl-5-pyrimidinyl)methyl-1-(2-chloroethyl)-3-ni-trosourea

AZQ:

2,5-diaziridinyl-3,6-biscarboethoxyamino-1,4-bezoquinone

BBB:

blood-brain-barrier

BCNU:

1,3-bis-(2-chloroethyl)-1-nitrosourea

BTB:

blood-tumour-barrier

CCNU:

1-(2-chlorethyl)-3-cyclohexyl-1-nitrosourea

CDDP:

Cis-diamminedichloroplatinum

DW:

distilled water

5-FU:

5-Fluorouracil

i.a.:

intraarterial

i.c.:

intracarotid

ICA:

internal carotid artery

i.v.:

intravenous

MCA:

middle cerebral artery

Me-CCNU:

1-(2-chloroethyl)-3-(trans-4-methylcyclohexyl)-1-nitrosourea

MST:

median survival time

MTP:

median time to tumour progression

MTX:

methotrexate

MW:

molecular weight

P:

octanol/water partition coefficient

PCNU:

1-(2-chloroethyl)-3-(2,6-dioxo-3-piperidyl)-1-nitrosourea

QAR:

quantitative autoradiography

Rd:

ratio of drug delivery by arterial compared to venous infusion

Re:

relationship between the ratio of the pharmacological effects by arterial compared to venous infusion

SSEP:

somatosensory evoked potentials

TCD:

transcranial doppler ultrasound

TIA:

transient ischaemic attack

VCR:

vincristine

VM-26:

teniposide

VP-16:

etoposide

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Authors and Affiliations

  1. Neurosurgical Clinic, Saarland University Medical School Homburg/Saar, Germany

    F. Loew & L. Papavero

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  1. F. Loew
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  2. L. Papavero
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Editor information

Editors and Affiliations

  1. London, UK

    L. Symon

  2. Brussels, Belgium

    J. Brihaye

  3. Bordeaux, France

    F. Cohadon

  4. Rome, Italy

    B. Guidetti

  5. Homburg/Saar, Germany

    F. Loew

  6. Edinburgh, England

    J. D. Miller

  7. Oslo, Norway

    H. Nornes

  8. Budapest, Hungary

    E. Pásztor

  9. Paris, France

    B. Pertuiset

  10. Zurich, Switzerland

    M. G. YaÅŸargil

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© 1988 Springer-Verlag/Wien

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Loew, F., Papavero, L. (1988). The Intraarterial Route of Drug Delivery in the Chemotherapy of Malignant Brain Tumours. In: Symon, L., et al. Advances and Technical Standards in Neurosurgery. Advances and Technical Standards in Neurosurgery, vol 16. Springer, Vienna. https://doi.org/10.1007/978-3-7091-6954-4_2

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  • DOI: https://doi.org/10.1007/978-3-7091-6954-4_2

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