Intraneoplastic Administration of Bleomycin in Intracerebral Gliomas: A Pilot Study

Abstract

As human malignant gliomas of the brain cannot be treated successfully by conventional means, i.e., bulk resection + radiotherapy, eventually combined with the systemic administration of cytostatic agents, we decided to start a trial consisting of stereotactic biopsy of the tumour and placement of a small catheter in the center of the tumour to administer chemotherapeutic agents. In contrast with those agents used in systemic administration that should be of small molecular size and lipid soluble to penetrate the CNS, for intraneoplastic drug delivery drugs could be used that do not pass the blood brain barrier. It seemed reasonable to chose a drug that will neither pass this barrier nor the brain-blood barrier. Besides that the drug should be a non-cell cycle specific drug as gliomas have a very low growth fraction ⁵ and should have shown at least some effectivity against glioma cells both in vivo and in vitro ^7-9. Bleomycin fulfilled all these criteria ^{2, 6} and has been taken as the first agent to test in this way.