Symptomatic Remote Cyst after BCNU Wafer Implantation for Malignant Glioma

Hideaki MATSUMURA; Eiichi ISHIKAWA; Masahide MATSUDA; Noriaki SAKAMOTO; Hiroyoshi AKUTSU; Shingo TAKANO; Akira MATSUMURA

doi:10.2176/nmc.cr.2017-0218

A phase II study of radiation with concomitant and then sequential temozolomide (TMZ) in patients (pts) with newly diagnosed supratentorial high grade malignant glioma (MG) who have undergone surgery with carmustine (BCNU) wafer insertion

Journal of Clinical Oncology ◽

10.1200/jco.2005.23.16_suppl.1547 ◽

2005 ◽

Vol 23 (16_suppl) ◽

pp. 1547-1547 ◽

Cited By ~ 4

Author(s):

R. V. Larocca ◽

T. W. Vitaz ◽

D. J. Morassutti ◽

M. J. Doyle ◽

S. D. Glisson ◽

...

Keyword(s):

Malignant Glioma ◽

Phase Ii ◽

Phase Ii Study ◽

High Grade ◽

Newly Diagnosed ◽

Bcnu Wafer

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Use of Gliadel (BCNU) Wafer in the Surgical Treatment of Malignant Glioma: A 10-Year Institutional Experience

Annals of Surgical Oncology ◽

10.1245/s10434-008-0048-2 ◽

2008 ◽

Vol 15 (10) ◽

pp. 2887-2893 ◽

Cited By ~ 150

Author(s):

Frank J. Attenello ◽

Debraj Mukherjee ◽

Ghazala Datoo ◽

Matthew J. McGirt ◽

Eileen Bohan ◽

...

Keyword(s):

Surgical Treatment ◽

Malignant Glioma ◽

Bcnu Wafer ◽

Institutional Experience

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Growth pattern of tumor recurrence following bis-chloroethylnitrosourea (BCNU) wafer implantation in malignant glioma

Journal of Clinical Neuroscience ◽

10.1016/j.jocn.2012.01.060 ◽

2013 ◽

Vol 20 (3) ◽

pp. 429-434 ◽

Cited By ~ 8

Author(s):

Lutz Dörner ◽

Ahmad Mustafa ◽

Axel Rohr ◽

H. Maximilian Mehdorn ◽

Arya Nabavi

Keyword(s):

Malignant Glioma ◽

Growth Pattern ◽

Tumor Recurrence ◽

Bcnu Wafer

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Interstitial chemotherapy with drug polymer implants for the treatment of recurrent gliomas

Journal of Neurosurgery ◽

10.3171/jns.1991.74.3.0441 ◽

1991 ◽

Vol 74 (3) ◽

pp. 441-446 ◽

Cited By ~ 333

Author(s):

Henry Brem ◽

M. Stephen Mahaley ◽

Nicholas A. Vick ◽

Keith L. Black ◽

S. Clifford Schold ◽

...

Keyword(s):

Malignant Glioma ◽

Dose Group ◽

Malignant Gliomas ◽

Chemotherapeutic Agents ◽

Therapeutic Drug ◽

Recurrent Malignant Glioma ◽

Content Type ◽

Interstitial Chemotherapy ◽

Bcnu Wafer ◽

Fine Print

✓ Malignant gliomas have been difficult to treat with chemotherapy. The most effective agent, BCNU (carmustine), has considerable systemic toxicity and a short half-life in serum. To obviate these problems, a method has been developed for the local sustained release of chemotherapeutic agents by their incorporation into biodegradable polymers. Implantation of the drug-impregnated polymer at the tumor site allows prolonged local exposure with minimal systemic exposure. In this Phase I–II study, 21 patients with recurrent malignant glioma were treated with BCNU released interstitially by means of a polyanhydride biodegradable polymer implant. Up to eight polymer wafers were placed in the resection cavity intraoperatively, upon completion of tumor debulking. The polymer releases the therapeutic drug for approximately 3 weeks. Three increasing concentrations of BCNU were studied; the treatment was well tolerated at all three levels. There were no adverse reactions to the BCNU wafer treatment itself The average survival period after reoperation was 65 weeks for the first dose group, 64 weeks for the second dose group, and 32 weeks for the highest dose group. The overall mean survival time was 48 weeks from reoperation and 94 weeks from the original operation. The overall median survival times were 46 weeks postimplant and 87 weeks from initial surgery. Eighteen (86%) of 21 patients lived more than 1 year from the time of their initial diagnosis and eight (38%) of 21 patients lived more than 1 year after intracranial implantation of the polymer. Frequent hematology, blood chemistry, and urinalysis tests did not reveal any systemic effect from this interstitial chemotherapy. Since the therapy is well tolerated and safe, a placebo-controlled clinical trial has been started. The trial will measure the effect of the second treatment dose on survival of patients with recurrent malignant glioma.

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STMO-01 Cerebral edema and perioperative epilepsy due to placement of BCNU wafer for malignant glioma

Neuro-Oncology Advances ◽

10.1093/noajnl/vdaa143.039 ◽

2020 ◽

Vol 2 (Supplement_3) ◽

pp. ii9-ii9

Author(s):

Yu Fujii ◽

Toshihiro Ogiwara ◽

Masahiro Agata ◽

Yoshiki Hanaoka ◽

Tetsuyoshi Horiuchi

Keyword(s):

Malignant Glioma ◽

Cerebral Edema ◽

Tumor Location ◽

Frequent Adverse Event ◽

Significant Parameter ◽

Bcnu Wafers ◽

Bcnu Wafer ◽

Postoperative Seizure ◽

Intensity Region ◽

Report Risk Factor

Abstract Introduction: Cerebral edema is the most frequent adverse event of BCNU wafer, which is used as local chemotherapy of malignant glioma. However, predictive factor of this event is unknown. Moreover, there is no consensus about cerebral edema and perioperative seizure, which is often observed in glioma. Here, we report risk factor of cerebral edema with BCNU placement and relationship with perioperative seizure in malignant glioma cases. Material and Method: Thirty-one case of adult malignant glioma who underwent BCNU placement in our institute between March 2013 to March 2019 were investigated. The patients were dichotomized to two groups; patient with postoperative transient cerebral edema (CE+ group) and patient without postoperative transient cerebral edema (CE- group). Result: Postoperative cerebral edema associated with placement of BCNU was observed in 9 out of 31 patients (29%). Tumor malignancy was significant parameter for postoperative cerebral edema (p=0.003). Other factors such as, age, gender, laterality, tumor location, primary or recurrent, number of BCNU wafers, duration of recurrence were not significant for postoperative cerebral edema. Seizure was seen in 14 patients (45%), and cerebral edema was not significant parameter for seizure. Tumor malignancy was significant parameters for postoperative cerebral edema. Tumor malignancy was significant parameters for seizure (p=0.0004). Although postoperative seizure was observed in 4 patients (44%) with CE+ group, neither maximum volume (mean 61.1 ml) nor change ratio (mean 354%) of FLAIR-high-intensity region were not related with postoperative seizure. Conclusions: Tumor malignancy was important factor for patients who underwent placement of BCNU wafer with postoperative cerebral edema and seizure. On the other hand, there were no relationship between postoperative cerebral edema and perioperative seizure in patients treated with BCNU wafer.

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