Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0017638 (glioma)
 30,880 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Between October 1985 and March 1988, Children's Cancer Study Group institutions entered 95 patients with recurrent brain tumors into a Phase II trial of carboplatin 560 mg/m2 every 4 weeks. Complete or partial responses were observed for one of 19 evaluable children with brainstem glioma, two of 14 with ependymoma, six of 19 with medulloblastoma or central nervous system primitive neuroectodermal tumor (PNET), and none of 15 with high-grade astrocytoma. Of 33 children with medulloblastoma, ependymoma, or central nervous system PNET, five of 12 with no prior cisplatin exposure had responses, and two of 21 with prior cisplatin exposure had responses (P = 0.03). Thirty-four percent of patients had absolute neutrophil count nadirs less than 500/microliters, and 37% had platelet count nadirs less than 25,000/microliters. Sixteen percent had moderate to severe otoxicity, 10% had nausea and vomiting, and none had nephrotoxicity.
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PMID:Carboplatin in childhood brain tumors. A Children's Cancer Study Group Phase II trial. 224 86

Between February 1986 and December 1988, 44 patients were treated with stereotactic radiosurgery using a standard linear accelerator. Twenty one patients were treated for cerebrovascular abnormalities and 23 patients were treated for intracranial tumors. Fifteen of the 23 patients treated for intracranial tumors had received previous radiotherapy. The range of doses given by radiosurgery was 1000-2500 cGy. Nausea and vomiting occurred in seven patients within six hours of treatment. The incidence and symptoms were correlated with the dose of radiation to the vomiting center (area postrema) with the median dose to the postrema in symptomatic patients being 618 cGy compared to a range of less than 5 to 184 cGy in the remaining 36 asymptomatic patients. Temporary alopecia occurred in a single patient who received 400 cGy to the scalp. Alopecia did not occur in the remaining 43 patients who received from less than 5 to 175 cGy. Two patients treated for arteriovenous malformations developed an enhancing lesion on CT scanning (one with cerebral edema) on follow-up CT scanning six and twenty-eight months following radiosurgery. The location of these enhancing lesions corresponded to the volumes treated. In one patient, the enhancing pattern and edema disappeared within 18 months of treatment and no neurological deficits developed. Aphasia occurred in one patient treated for a recurrent glioma two hours following treatment to the left temporal lobe and cleared within 12 h of radiosurgery. One patient with an arteriovenous malformation of the pons developed weakness of the contralateral arm and leg six weeks following treatment and this has slowly resolved over the last 12 months. In conclusion, the complications to date have been self-limited and appear to be directly related to the dose and area of brain treated. Prior radiation therapy has not been associated with increased risk of complication in patients treated with radiosurgery for recurrent tumors to date.
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PMID:Stereotactic radiosurgery of the brain using a standard linear accelerator: a study of early and late effects. 234 48

Fifteen patients, 12 with glioblastoma multiforme and 3 with anaplastic astrocytoma, were treated with "eight-drugs-in-one-day" chemotherapy [methylprednisolone 300 mg/m2, vincristine 1.5 mg/m2 (maximum of 2 mg/cycle), CCNU 75 mg/m2, procarbazine 75 mg/m2, hydroxyurea 3,000 mg/m2, cisplatin 90 mg/m2, cytosine arabinoside 300 mg/m2, and imidazole carboxamide 150 mg/m2]. All patients had prior brain irradiation but none had previous chemotherapy. The population included 10 patients with progressive disease after irradiation and 5 who presented within 2 months of completing radiation. Patients received an average of 5 monthly cycles of chemotherapy. Three patients achieved a complete and 2 a partial response (CR + PRrate was 33%). The median survival time was 46 weeks. Myelosuppression was the dose-limiting toxicity. Leucocyte counts between 2.0-4.5 x 10(3)/mm3 were observed in 40% of patients, between 1.0- less than 2.0 x 10(3)/mm3 in 33%, and less than 1.0 x 10(3)/mm3 in 7%. Platelet counts between 50-130 x 10(3)/mm3 were observed in 27% of patients, and less than 50 x 10(3)/mm3 in 33%. Six patients suffered infections, 4 had reversible renal toxicity, 2 developed paresthesias, and one a debilitating myopathy related to treatment with dexamethasone. Ototoxicity was seen in 3 patients. Two patients developed pulmonary emboli. Nine patients had nausea and vomiting, in one case associated with Candida esophagitis. One long-term survivor developed necrosis of the corpus callosum and dementia. Four patients discontinued treatment after an average of 3.5 cycles because of toxicity. Although extremely toxic, this regimen has modest activity in previously irradiated adult patients with malignant glioma.
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PMID:Eight-drugs-in-one-day chemotherapy in postirradiated adult patients with malignant gliomas. 258 61

Thirty-one adult patients with malignant glioma (23 with glioblastoma multiforme, six with anaplastic astrocytoma, and two with brainstem glioma) were treated with up to ten cycles of "eight-drugs-in-one-day" chemotherapy (methylprednisolone 300 mg/m2, vincristine 1.5 mg/m2 [maximum of 2 mg/cycle], CCNU 75 mg/m2, procarbazine 75 mg/m2, hydroxyurea 3000 mg/m2, cisplatin 90 mg/m2, cytosine arabinoside 300 mg/m2, and imidazole carboxamide 150 mg/m2). Chemotherapy was planned as two cycles before and eight cycles after 60 Gy of involved brain irradiation. A total of 117 cycles of chemotherapy was administered. There was one treatment-related death. Myelosuppression was the most frequent toxic effect (leucopenia was less than 1000/mm3 in 9% of cycles and 1000-2500/mm3 in 25%; thrombocytopenia was less than 100,000/mm3 in 33% of cycles). Sixteen patients developed infections requiring treatment, two of which were life-threatening. Five patients suffered ototoxicity. Nausea and vomiting were observed in 35% of patients. A reversible rise in creatinine was observed in five patients. One patient developed a severe motor neuropathy, and three patients developed mild peripheral neuropathies. Three patients had episodes of atrial fibrillation. One new bundle branch block with supraventricular tachycardia was observed in a patient with pulmonary embolus. Five patients developed thrombophlebitis, three of whom had pulmonary emboli. Two patients suffered strokes in areas anatomically separate from their tumor. Eleven patients declined to continue therapy after receiving an average of three cycles. Two had complete, and five had partial responses. The median survival time was 47 weeks. The responses and survival times observed are comparable to less toxic treatment protocols for adults with malignant gliomas.
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PMID:"Eight-drugs-in-one-day" chemotherapy administered before and after radiotherapy to adult patients with malignant gliomas. 272 May 98

Carboplatin is one of a series of cisplatin analogs now undergoing clinical investigation. Phase I and II trials in adults demonstrate activity in a number of human cancers and less toxicity than might be expected with the parent compound. This phase I trial was undertaken to establish the maximum tolerated dose and the recommended phase II dose in children treated by a 1-hour iv infusion every 4 weeks. Twenty-nine patients with recurrent or progressive tumor were entered in this study at the Children's Hospital of Los Angeles and Children's Memorial Hospital in Chicago between April 12, 1983, and November 27, 1984. Beginning with a dose of 350 mg/m2 (about 80% of the adult phase II dose), we escalated the dose in groups of patients to 670 mg/m2; dose-limiting myelosuppression was encountered at this dose. Fifty-seven infusions are at least partially evaluable for toxicity. Asymptomatic hypomagnesemia, hypocalcemia, and ototoxicity were observed infrequently, and nausea and vomiting were mild. One patient with a mixed glioma of the posterior fossa achieved a good partial response lasting 9 months. Stable disease for greater than or equal to 6 months was observed in three patients: one each with ependymoma, brain stem glioma, and spinal cord astrocytoma. The recommended pediatric phase II dose is 560 mg/m2 given as a 1-hour iv infusion every 4 weeks.
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PMID:Pediatric phase I trial of carboplatin: a Childrens Cancer Study Group report. 331 95

This paper presents a review of the progressive clinical trials of the hypoxic cell radiosensitizer, misonidazole, in the Radiation Therapy Oncology Group (RTOG). Presentation is made of all the schemas of the recently completed and currently active RTOG Phase II and Phase III studies. Detailed information is provided on the clinical toxicity of the Phase II trials, specifically regarding neurotoxicity. With limitations in drug total dose, a variety of dose schedules have proven to be tolerable, with a moderate incidence of nausea and vomiting and mild peripheral neuropathy, and a low incidence of more severe peripheral neuropathy or central neuropathy. No other organ toxicity has been seen, specifically no liver, renal or bone marrow toxicities. The clinical pharmacologic monitoring of misonidazole blood levels has been satisfactory with good correlation between the group-wide (Phase II) UV values and the HPLC values from the Phase I study. The patient accrual of the trials has been rapidly increasing and an early analysis suggests efficacy better than previous radiation experience. A series of eight Phase III trials are currently underway or proposed in the RTOG and the results of these are pending. An additional Phase III malignant glioma trial in the Brain tumor Study Group is described.
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PMID:Radiation Therapy Oncology Group clinical trials with misonidazole. 702 42

A totally thrombosed large arteriovenous malformation (AVM) which operated as an intracranial space occupying lesion was presented. The patient was a 24-year-old woman who had had frequent attacks of loss of consciousness since the age of 13 years and had been on anticonvulsant medication at the psychiatric department of our hospital. She was referred to our clinic with bitemporal girdle pain, nausea and vomiting. Neurological examination revealed right homonymous hemianopsia, sensory aphasia and choked discs in both ocular fundi. Computed tomogram demonstrated a well defined large high density area with mottled calcification in rostromedial part of the left occipital lobe. The midline structures were displaced to the right side with deformity of the lateral ventricles. Left carotid angiogram showed upward displacement of M2 portion of the left middle cerebral artery. Fine vessels were observed as a capillary blush at the distal part of the pericallosal artery. Teratoma or calcified glioma was suspected preoperatively. But surgery revealed that the large mass was a totally thrombosed AVM. Possible mechanisms for the spontaneous enlargement of the thrombosed AVM were discussed. Cases of totally thrombosed AVM causing displacement of the midline structures or deformity of the ventricles without massive hematoma or disturbance of cerebrospinal fluid circulation have not yet been reported.
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PMID:[Totally thrombosed large arteriovenous malformation--a case report]. 715 97

This paper presents a review of the progressive clinical trials of the hypoxic cell radiosensitizer, misonidazole, in the United States. Presentation is made of all of the schemata of the recently completed and currently active Radiation Therapy Oncology Group (RTOG) phase II and phase III studies. Detailed information is presented on the clinical toxicity of the phase I and II trials, specifically regarding neurotoxicity. With limitations in drug total dose, a variety of dose schedules have proven to be tolerable, with a moderate incidence of nausea and vomiting and mild peripheral neuropathy, and a low incidence of more severe peripheral neuropathy or central neuropathy. No other organ toxicity has been seen, specifically no liver, renal, or bone marrow toxicities. The clinical pharmacologic monitoring of misonidazole blood levels has been satisfactory with good correlation between the group-wide (phase II) UV values and the HPLC values from the phase I study. The patient accrual of the trials has been rapidly increasing and an early analysis suggests efficacy which is at least comparable to previous radiation experience. A series of the five phase III trials are currently underway in the RTOG and the results of these are pending. An additional malignant glioma trial in the Brain Tumor Study Group is described.
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PMID:Clinical trials of misonidazole in the United States. 721 64

An unusual case of an intracranial glioma which demonstrated extramedullary growth is reported. The patient was a 39-year-old woman who had experienced headache, nausea and vomiting for about 1 month. On admission she showed slight disturbance of consciousness and bilateral papilloedema. CT scan and MR imaging disclosed a mass approximately 5 cm in diameter in the right frontal region, with clear demarcation from the neighboring gyri. Right external carotid angiogram revealed A-V shunts in the mass, but by right internal carotid angiogram, no abnormal findings were disclosed except for the deviation of normal intracranial vessels due to the existence of the mass. Therefore, a preoperative diagnosis of extramedullary tumor such as meningioma and epidermoid was made. Right frontal craniotomy was performed, and the tumor was proven to exist in subdural space. The boundary of the tumor to the brain surface was distinct except for one part. Histopathologically, the tumor cells had abundant eosinophillic cytoplasms, with eccentric-distribution of their nuclei. Furthermore, they were positive for staining for GFAP and S-100 protein. Therefore, a final diagnosis of gemistocytic astrocytoma was made. Reviewing some references the authors discuss here the form of development and progression of intracranial gliomas which demonstrate extramedullary growth such as this case.
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PMID:[A case of intracranial glioma which demonstrated extramedullary growth]. 781 73

The toxicity and therapeutic effect of the ventriculolumber perfusion of 3-[(4-amino-2-methyl-5-pyrimidinyl)methyl-1-1(2-chloroethyl)-1-nitros our ea hydrochloride (ACNU) against subarachnoid dissemination of gliomas were studied. Twenty-one patients (6 patients with anaplastic glioma, 7 with glioblastoma and 8 with medulloblastoma or PNET) received ventriculolumber perfusion of ACNU when they were diagnosed as having subarachnoid dissemination. The course of perfusion and cumulative dose of ACNU was 10 times and 95 mg on average, respectively. Most of the patients received systemic chemotherapy in combination with perfusion therapy and some patients with radiotherapy. Response rate was 17% and median survival time after the diagnosis of dissemination was 12 months for anaplastic gliomas, 29% and 12 months for glioblastoma, and 88% and over 25 months for medulloblastoma and PNET. The ventriculolumber perfusion of ACNU was performed for prophylactic purpose in 7 patients with high risk at the early postoperative period in combination with conventional adjuvant therapy. The course of perfusion and cumulative dose of ACNU was 2.3 times and 21 mg on average, respectively. One patient developed subarachnoid dissemination and died 22 months after surgery. Other 6 patients survived without dissemination on median over 29 months after surgery. Side effects encountered were headache in 4 patients, nausea and vomiting in 5, a convulsion in 2, right facial weakness in 1, fecal incontinence in 3 and meningitis in 2. They were all temporary except for facial weakness occurred in one patient. These data suggest that the ventriculolumber perfusion of ACNU is a safe and useful in the treatment and prophylaxis against the subarachnoid dissemination of gliomas.
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PMID:Ventriculolumber perfusion of 3-[(4-amino-2-methyl-5-pyrimidinyl)-methyl]-1-(2-chloroethyl-1-nitrosou rea hydrochloride for subarachnoid dissemination of gliomas. 969 73


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