Effects of Intracarotid Administration of Nitrogen Mustard on Normal Brain and Brain Tumors

French, John D.; West, P. M.; Amerongen, F K Von; Magoun, H. W.

doi:10.3171/jns.1952.9.4.0378

Cited by 64 publications

(22 citation statements)

References 7 publications

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“…12'4' 2~ Others have observed cases of leukoencephalopathy which appear on computerized tomography scans as hypodense areas representing focal sites of cerebral toxicity and necrosis. 9,11,12,23 Suggestions have been postulated to explain these random instances of focal toxicity in different trials, including the presence of excess alcohol in the drug formulations or precipitation of the drugs prior to administration, s' 16 We propose that local toxicity can result from non-uniform distribution of drug to the infused region due to streaming of the drug solution from the catheter tip. If streaming persists beyond the ICA, some areas of the brain may receive excessively high toxic concentrations of drug, while other areas may receive subtumoricidal levels.…”

mentioning

confidence: 98%

Mixing studies during intracarotid artery infusions in an in vitro model

Lutz¹,

Dedrick²,

Boretos³

et al. 1986

Journal of Neurosurgery

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Sporadic instances of retinal damage and of focal brain toxicity have been observed following intracarotid artery infusions of chemotherapeutic agents (such as BCNU and cis-platinum) for the treatment of glioblastomas. The episodic nature of these toxicities is consistent with the possibility that the drug solutions were streaming from the catheter tip and, therefore, were not well mixed or not uniformly distributed in all branches distal to the catheter tip location. To test this hypothesis, an in vitro system was fabricated which included a transparent model of the human carotid artery and its major branches. These were furnished with pulsatile flow of a blood simulant. Dye solutions infused at several infusion rates through various types of catheters in both supraophthalmic and infraophthalmic positions were monitored and recorded on videotape and photographic film. The effluent streams from distal branches of the model were collected, and the relative concentrations of dye in each branch were determined spectrophotometrically. The results indicate that infusate streaming occurs at low infusion rates. In some cases, the concentration in a given branch can be at least five times the expected concentration. Similar occurrences of streaming in vivo could cause focal toxicity. Methods to improve mixing should be used during intra-arterial administration of drugs; these include increasing the infusion rates and improving catheter tip design.

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mentioning

confidence: 98%

Mixing studies during intracarotid artery infusions in an in vitro model

Lutz¹,

Dedrick²,

Boretos³

et al. 1986

Journal of Neurosurgery

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“…On the other hand, platinum analogs showed fewer cerebral side effects when given by the IA route; neurotoxicity such as retinopathy was rare, especially after the introduction of selective IA infusion 12 – 16…”

Section: Discussionmentioning

confidence: 99%

“…Intra-arterial (IA) therapy for malignant brain tumors, especially high-grade gliomas, has been administered since the 1950s and 1960s when the structure of the blood–brain barrier (BBB) was first described 2 – 4. Only with the advent of modern techniques used by endovascular neurosurgeons as a result of their experience gained in the treatment of vascular diseases was it possible to proceed with the release of chemotherapeutic agents in an ultraselective mode by means of superselective IA cerebral infusion (SIACI).…”

Section: Introductionmentioning

confidence: 99%

Endovascular superselective treatment of brain tumors: a new endovascular era? A quick review

Peschillo

Miscusi

Missori

2014

J NeuroIntervent Surg

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“…During the 1950's and 1960's, several methods for i.a. infusion of a number of antitumor agents were utilized in malignant brain tumor (1)(2)(3)(4)(5). However, unacceptable complications associated with drug toxicities and inherent difficulties in the infusion techniques thwarted further progress in i.a.…”

Section: Introductionmentioning

confidence: 99%

Complications associated with intra-arterial BCNU administered in combination with vincristine and procarbazine for the treatment of malignant brain tumors

et al. 1984

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We have used intra-arterial (i.a.) 1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU) either alone or as part of adjuvant chemotherapy in patients with malignant brain tumors over a 3 year period (1979-1982). The i.a. BCNU technique was used 111 times to infuse 134 arteries in 37 patients. These patients, 28 cases with glial tumor and 9 cases with brain metastasis, received i.a. BCNU in combination with Vincristine and Procarbazine every 6 weeks. Complications encountered were transient and included: periorbital erythralgia or occipital-nuchal pain in 23 (62%), mild confusion and disorientation in 14 (38%), and ipsilateral conjunctival edema in 10 (27%). Reversible myelosuppression was not found. Our findings suggest that BCNU (100 mg/M2) may be given by i.a. infusion in combination chemotherapy without persistent severe untoward effects with a cumulative dose of 700 mg/M2.

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Effects of Intracarotid Administration of Nitrogen Mustard on Normal Brain and Brain Tumors

Cited by 64 publications

References 7 publications

Mixing studies during intracarotid artery infusions in an in vitro model

Mixing studies during intracarotid artery infusions in an in vitro model

Endovascular superselective treatment of brain tumors: a new endovascular era? A quick review

Complications associated with intra-arterial BCNU administered in combination with vincristine and procarbazine for the treatment of malignant brain tumors

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