Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0017636 (glioblastoma)
 18,345 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

With the new technique of transcranial Doppler sonography it is possible to record transient changes of blood flow within the major basal cerebral arteries. The injection of saline and contrast medium into the internal carotid artery is followed immediately by a marked turbulence of flow within the middle cerebral artery depending on the amount and pressure of the injected material. In addition, the flow in the middle cerebral artery is increased by the injection of saline, but reduced by the injection of contrast medium for 3 to 4 seconds and finally increased for 8 to 10 seconds. No changes are seen on the contralateral side. The recordings of blood flow within the middle cerebral artery during 1.3-bis(2-chlorethyl)nitrosurea (BCNU) perfusion of glioblastoma recurrences via a flow-directed balloon catheter showed no obvious alterations during injections into the upper part of the carotid siphon, but a marked reduction of diastolic flow during injections into the middle cerebral artery. The reduction of flow may explain some of the complications of angiography.
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PMID:Transcranial Doppler monitoring of blood flow in the middle cerebral artery during angiography and drug perfusion. 298 Apr 22

26 patients with astrocytoma grade II-III, and 36 with malignant glioma (astrocytoma grade IV or glioblastoma) were submitted three days after surgery to a cycle of combination chemotherapy, including BCNU, VCR, PCZ (BVP). Eighteen days after surgery, patients received 40 Gy (astrocytoma grade II-III) or 45 Gy (malignant glioma) of megavoltage whole-brain irradiation, with an additional boost to the 'tumor' bed of 20 Gy, delivered in 6 weeks. Vincristine was injected weekly during radiotherapy. At the end of radiotherapy, patients received BVP every 6 weeks for at least 8 cycles or until a recurrence or progressive disease. Performance status of grade 1 or 2 was achieved in 15 (60%) and in 5 (20%), respectively, of patients with astrocytoma grade II-III after 6 months, and in 6 ps. (29%) and in 9 ps. (42%) after 12 months of follow-up. Only 2 (5.5%) and 18 (64%) patients with malignant glioma achieved a performance status of grade 1 or 2 after 6 months, and these proportions are 6% and 35%, respectively, after 12 months. After a 5-year follow-up, 59% of patients with astrocytoma are still alive, with a median survival time of 60+ months, whereas only 4% of patients with malignant glioma are alive, with a median of 11.2 months.
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PMID:Radiotherapy and combination chemotherapy with carmustine, vincristine, and procarbazine (BVP) in primary brain tumors. 298 23

This retrospective study concerns 55 adult patients with supratentorial glioblastoma. The tumours were treated by complete or partial surgical excision whenever possible (31 cases), radiotherapy (22 cases) in doses of 60 Gy over 6 to 7 weeks (40 Gy with telecobalt and 20 Gy with superimposed electrons) and multiple chemotherapy (10 cases) with VM26 and CCNU or BCNU. Although the number of patients in some categories was too small for statistical evaluation, the results obtained were in agreement with those found in the literature and indicative of what can be expected. In patients with inoperable tumours the mean survival was increased from 2 to 8 months by radiotherapy or chemotherapy given separately, and from 2 to 9 or 10 months only when these two methods were combined. The mean survival of patients with partial tumoral excision was 2.5 months extended to 10 months after post-operative radiotherapy; one patient in this group who received both radiotherapy and chemotherapy is still alive after more than 5 years. In patients with macroscopically satisfactory excision, the 12 months good quality survival obtained by surgery was apparently prolonged to 22 months with radiotherapy; 3 of these patients who had both radiotherapy and chemotherapy after surgery are alive and in good condition after 15, 16 and 28 months respectively.
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PMID:[Supratentorial glioblastoma in adults. Therapeutic results]. 298 1

The rationale for, methodology of, and experience with intra-arterial BCNU infusion therapy of malignant glioma are described. This approach achieves tumor levels of drug four times greater than equal doses infused intravenously, and has been used to treat 79 patients over the course of 4 years. The drug was given in 192 infraophthalmic and 66 supraophthalmic carotid artery infusions. Patients who were treated via infraophthalmic carotid artery infusion following tumor recurrence (after both operation and irradiation) survived 54 additional weeks (92 weeks after initial diagnosis). Patients who were treated with BCNU immediately after initial irradiation therapy survived 64 weeks (infraophthalmic carotid artery infusion) and 49.5 weeks (supraophthalmic carotid artery infusion). The major ocular complications (pain and diminished visual acuity) associated with infraophthalmic carotid artery infusion are avoided by selective balloon-guided supraophthalmic carotid artery administration. However, both approaches were associated with white-matter changes, seen as diminished absorption on computerized tomography scans, in 20% of patients treated following irradiation therapy. This toxicity appears to preclude intra-arterial BCNU treatment in the immediate postirradiation period. Better results are being achieved with our current therapy, which involves four infusions of BCNU (400 mg every 4 weeks) into the infraophthalmic or supraophthalmic carotid artery in advance of irradiation. Cisplatin infusions (60 to 90 mg/sq m every 5 weeks) are offered for recurrent glioblastoma.
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PMID:The rationale and methodology for intra-arterial chemotherapy with BCNU as treatment for glioblastoma. 299 15

Two continuous human glioma derived cell lines, LI and DF, were established in our laboratory. Both cell lines showed cytological features and in vitro behavior similar to those of the respective original neoplasms. These two lines were characterized for their main biological properties including in vitro and in vivo growth rate, clonogenic ability and tumorigenicity in nude mice. The plating efficiencies were generally high both during exponential and stationary growth phases and a high tumorigenicity was observed. All injected nude mice developed tumors. The two lines were tested for chemosensitivity to 1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU) and cis-Diamminedichloroplatinum II (DDP). Heterogeneity in biological features and in drug sensitivity was observed. Exposure of the two lines to BCNU and DDP showed that the glioblastoma (LI) was less sensitive than the anaplastic astrocytoma (DF). For both lines BCNU was more effective on cells in plateau than in exponential phase, while the killing effect of DDP was not phase-dependent.
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PMID:Establishment, characterization and chemosensitivity of two human glioma derived cell lines. 322 39

Three in vitro clonogenic assays were used to determine the sensitivity of an established human glioblastoma cell line (U251-MG) to five chemotherapeutic agents. The colony-forming efficiency of untreated culture was 0.695 +/- 0.170 in a monolayer assay with irradiated feeder cells, 0.018 +/- 0.006 in a low-O2 agar assay, and 0.049 +/- 0.021 in a two-layer agar system with nutrient-enriched medium (p less than 0.001). Comparison of the slope of the regression line for the dose-response curve and the interpolated ID90 for each drug showed that U251-MG was equally sensitive to aziridinylbenzoquinone and dianhydrogalactitol in all three assays. The sensitivity of this cell line to 1,3-bis-(2-chloroethyl)-1-nitrosourea (BCNU), cis-dichlorodiammineplatinum (II) (CDDP) and 9-hydroxy-2-N-methylellipticine (HME), however, varied depending on the assay used. In no instance did U251-MG show greater sensitivity (lower ID90 or steeper slope) in the low-O2 agar assay than in the other assays. BCNU and CDDP were least active in the monolayer assay, whereas HME showed both the lowest ID90 and steepest slope using this technique. We conclude that different in vitro tumour clonogenic assays show different colony-forming efficiencies for the same cell line and may show different responses to certain drugs. Identification of accurate predictive models of drug sensitivity will require correlative in vivo and in vitro studies.
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PMID:Comparison of in vitro cloning assays for drug sensitivity testing of human brain tumours. 326 6

A 41 year old male presented with headache, lethargy, and ataxia and found to have a left temporal lobe mass and a leukoerythroblastic peripheral blood smear. The latter prompted an iliac crest bone marrow biopsy on which a diagnosis of metastatic glioma was made and verified by immunohistologic characterization. The patient was treated with cranial irradiation and simultaneous systemic BCNU (bis-dichloroethylnitrosurea) with complete response. This case with diffuse bone marrow involvement demonstrates that a glioblastoma is capable of extracranial metastases without previous intervention. From a review of reported cases of gliomas of extraneural metastasis, it is concluded that untreated gliomas are capable of vascular spread although less frequently than previously manipulated tumors.
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PMID:Intracranial astrocytoma with diffuse bone marrow metastasis: a case report and review of the literature. 329 52

A phase I study of the intracarotid administration of PCNU was conducted in patients with intracerebral tumors recurring after cranial radiation. Seventeen patients were treated including 16 with recurrent gliomas or glioblastomas and 1 with recurrent brain metastases from adenocarcinoma of the lung. An additional patient received a vertebral artery infusion of PCNU for a recurrent glioblastoma. Seven of 17 patients receiving intracarotid PCNU responded for a response rate of 41%. If only evaluable patients with gliomas are considered, the response rate was 44%. Tumor grade at time of initial diagnosis, exposure to prior chemotherapy, and dose of PCNU did not appear to have a major impact on response rate. Zubrod performance status 3 patients had a lower response rate (25%) than did patients with performance status 1 or 2 (response rate 63%). Thrombocytopenia and reversible central nervous system toxicity were dose limiting at a PCNU dose of 110 mg/m2. Two patients had possible permanent central nervous system toxicity. Three patients had permanent ipsilateral visual impairment, including one at the lowest dose used into the carotid artery (60 mg/m2). Orbital pain appeared to be substantially less than that seen with intracarotid BCNU but headaches may have been somewhat more common. The single patient receiving a vertebral artery infusion developed marked headaches and restlessness after receiving 25 mg/m2 of a planned 75 mg/m2 treatment into the vertebral artery and the treatment had to be discontinued. Symptoms were rapidly reversible upon stopping the medication. Our overall impression is that intracarotid PCNU causes less ocular pain but more transient central nervous system toxicity than does intracarotid BCNU.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Phase I study of intracarotid PCNU. 368 87

Eleven patients with recurrent malignant glioma were treated with single high doses of BCNU ranging from 600 to 1400 mg/sq m. To prevent the characteristic late myelosuppression observed after conventional doses of BCNU, autologous bone marrow harvested just before drug treatment was infused 24 to 36 hours after therapy. Higher doses of BCNU causes earlier and more profound myelosuppression; one patient died on pancytopenia, breakdown of the gut epithelium, and Clostridium septicemia 10 days after receiving 1400 mg/sq m of BCNU. All patients experienced transient emesis; four developed transient elevation of hepatic enzymes, two reversible interstitial pulmonary infiltrates, and two who received 1400 mg/sq m BCNU suffered irreversible cortical damage. Eight patients receiving 600 to 1200 mg/sq m demonstrated reconstitution of polymorphonuclear leukocytes an platelets within at least 30 days after treatment. With a follow-up time of up to 19 months, four patients improved, three stabilized, and three deteriorated and died. The median survival time was 7 months. Computerized tomography performed on patients receiving constant corticosteroids showed diminished contrast enhancement and mass effect in eight patients. High-dose BCNU at doses up to 1200 mg/sq m with marrow rescue is a feasible approach to the treatment of patients with glioblastoma.
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PMID:High-dose BCNU with autologous bone marrow rescue for recurrent glioblastoma multiforme. 625

Based on preliminary favorable results with the use of postoperative high-dose radiation therapy for malignant gliomas and encouraging experimental studies which indicated that fractionated does of BCNU given 16 hours before irradiation significantly enhanced the effect of radiation both in vitro and in vivo, the Eastern Cooperative Oncology Group (ECOG) decided to explore the use of high-dose radiation therapy in combination with pulsed low doses of Group (ECOG) decided to explore the use of high-dose radiation therapy in combination with pulsed low doses of BCNU in a high-risk Phase I-II pilot study. The radiation therapy consisted of delivering 6000 rad to the whole brain plus a boost of 1000 rad to the tumor. BCNU was given i.v. 16 hours before the next radiation fraction with doses of 20 mg/M2 twice weekly for six weeks beginning on the second day of irradiation. Twelve patients were treated (5 with Grade III and 7 with Grade IV Astrocytomas). The median survival for the entire group was 80 weeks (30 weeks for Grade IV and 210 weeks for Grade III tumors). These results are not difficult from what was achieved by high-dose radiation alone. Subsequent experimental data seem to indicate that probably the smallest dose of BCNU that should be used in pulsed BCNU combined modality therapy is 80 mg/M2. In general, the treatment as offered in this study was well tolerated. There were no fatal or life-threatening hematologic toxicities and only one patient exhibited a transitory leukopenia of 1600.
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PMID:High-dose radiation therapy with low-dose (pulsed) BCNU in malignant gliomas: an Eastern Cooperative Oncology Group (ECOG) report. 628 58


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