No abstract available.
Carmustine* ; Pulmonary Fibrosis*

The outlook for patients with malignant gliomas of the brain remains rather poor. However, after many experience of decades, the data indicate that some improvements seemed to have occurred with following adjuvant treatments after surgery; 1) High dose post-operative radiation therapy 6000-7000 rad/7-8 week. 2) High dose irradiation with BCNU combined therapy(ECOG). 3) Multiple daily fractionated radiotherapy combined with or without misonidazole. 4) Intracranial implant or intraoperative electron therapy.
Brain ; Carmustine ; Glioma* ; Humans ; Misonidazole ; Radiotherapy*

Eight patients with recurrent oligodendroglioma were treated with 1.3-bis(2-chloroethyl) nitrosourea(BCNU) and CDD continuous infusion chemotherapy. They were 5 with benign oligodendrogliomas and 3 with anaplastic oligodendrogliomas. All the recurrent tumors had been treated with surgery and radiotherapy. Four patients had already received chemotherapy with ACNU. Seven of them showed response to continuous infusion chemotherapy. The time from the response to progression was 15 to 67 weeks. No severe complication of the chemotherapy was found. In conclusion, BCNU-CDDP continuous infusion chemotherapy is an effective treatment modality in recurrent oligodendrogliomas.
Carmustine ; Drug Therapy* ; Humans ; Nimustine ; Oligodendroglioma* ; Radiotherapy

We describe a case of mycosis fungoides (infiltrative plaque type) in an 86-year-old male. He had experienced dark erythematous round plaques on the face, trunk, buttock, upper and lower extremities. Histopathologic findings revealed band-like superficial dermal infiltration of atypical lymphocytes, epidermotropism, and Pautrier's microabscess in the epidermis. The infiltrative cells were positivly stained with CD3, but not with a CD20. He was treated with a topical application of 0.2% carmustine, but he died due to poor general condition and septicemia.
Aged, 80 and over ; Buttocks ; Carmustine ; Epidermis ; Humans ; Lower Extremity ; Lymphocytes ; Male ; Mycosis Fungoides* ; Sepsis

BACKGROUND: Mycosis fungoides (MF) is the most frequent form of cutaneous lymphoma. Early stage MF is known to be responsible to the various topical and systemic therapies. However, there have been few clinical reviews of the treatment modalities of the early stoge MF in Korea. OBJECTIVE: The aim of this study is to investigate the therapeutic response of early MF to different treatment modalities. METHODS: The medical records, clinical photographs, and biopsied tissues, of fifty three cases of early MF were reviewed. RESULTS: The mean age at diagnosis of early MF was 43.0 years old (varied between 9 and 81 years old). Twenty three (43.4%) were male and thirty (56.6%) were female. Topical carmustine (bis-chloroethyl-nitrosourea, BCNU) was the most commonly used treatment modality in the early MF (34.0%). Patients treated by BCNU in stage IA (<10% skin involved) showed a response rate of 85.7%. Early MF recorred in only one patient after 93 months. However BCNU was not effective for the patients in stage IB (> or =10% skin involved). Even Psoralen plus UVA (PUVA) therapy, which was most efficient in stage IB, revealed a high relapse rate after one year. CONCLUSION: BCNU has been most commonly used for the treatment of early MF during the past 10 years in the authors' hospital. It showed a comparatively high response rate, and the relapse rate of BCNU was lower than for other therapies in stage IA. However many treatments became ineffective when MF progressed to stage IB. Therefore the authors confirm that early diagnosis and proper therapy are most important for the treatment of early MF.
Carmustine ; Diagnosis ; Early Diagnosis ; Female ; Ficusin ; Humans ; Korea ; Lymphoma ; Male ; Medical Records ; Mycosis Fungoides* ; Recurrence ; Skin

OBJECTIVE: Nitric oxide(NO) is implicated in a wide range of biological processes in tumors and is produced in glioma. To investigate the role of NO and its interaction with the tumoricidal effects of anticancer drugs, we study the antitumor activities of NO donors, with or without anticancer drugs, in human glioma cell lines. METHODS: U87MG and U373MG cells were treated with the NO donors sodium nitroprusside(SNP) and S-nitroso-N-acetylpenicillamine(SNAP), alone or in combination with the anticancer drugs 1, 3-bis(2-chloroethyl)-1-nitrosourea(BCNU) and cisplatin. Cell viability, cell proliferation, DNA fragmentation, nitrite level, and the expression of Bcl-2 and Bax were determined. RESULTS: NO was markedly increased after treatment with SNP or SNAP; however, the addition of the anticancer drugs did not significantly affect NO production. NO donors or anticancer drugs reduced glioma cell viability and, in combination, acted synergistically to further decrease cell viability in a dose- and time-dependent manner. Cell proliferation was inhibited and apoptosis were enhanced by combined treatment. Bax expression was increased by combined treatment, whereas Bcl-2 expression was reduced. The antitumor cytotoxicity of NO donors and anticancer drugs differed according to cell type. CONCLUSION: BCNU or cisplatin can inhibit cell viability and proliferation of glioma cells and can induce apoptosis. These effects are further enhanced by the addition of a NO donor which modulates the antitumor cytotoxicity of chemotherapy depending on cell type. Further biological, chemical, and toxicological studies of NO are required to clarify its mechanism of action in glioma.
Apoptosis ; Biological Processes ; Carmustine ; Cell Line ; Cell Proliferation ; Cell Survival ; Cisplatin ; DNA Fragmentation ; Drug Therapy ; Glioma* ; Humans ; Nitric Oxide Donors* ; Nitric Oxide* ; Sodium ; Tissue Donors

In 17 cases of glioblastoma multiforme and 3 cases of anaplastic astrocytoma, ACNU chemotherapy was performed by intravenous(10 cases) and supraophthalmic or superselective intraarterial(10 cases) injection postoperatively combined with radiation therapy. The postoperative median survival time in 17 cases of glioblastoma multiforme was 15 months(7 cases alive), and those for intravenous(8 cases) and intraarterial(9 cases) were 16.3 months(2 case alive) and 13 months(5 cases alive) respectively. 3 cases of anaplastic astrocytoma(2 cases intravenous, 1 case intraarterial) are all alive and the average postoperative follow-up period was 22.5 months. The survival rate of patients with gliobalstoma multiforme at 18 months after operation was 47.6%, and those for intravenous and intraarterial were 57.6% and 36.5%. In an analysis of performance status at the time of 3 months following surgery, there was remarkable improvement of quality of life in 70% of glioblastoma multiforme treated. In postoperative 12 months, about 50% of gliobalstoma multiforme patients could carry their normal daily life. Systemic side effects such as leukopenia and thrombocytopenia occurred little more frequently in intravenous group than intraarterial group. But more serious local neurological complication such as visual loss(1 case) and leucoencephalopathy(1 case) occurred in intraarterial group. Platelet count were decreased maximally in the fourth week after ACUN administration.
Astrocytoma ; Brain Neoplasms ; Carmustine ; Drug Therapy* ; Follow-Up Studies ; Glioblastoma ; Glioma* ; Humans ; Leukopenia ; Nimustine* ; Platelet Count ; Quality of Life ; Survival Rate ; Thrombocytopenia

Prognosis for patients with a malignant glioma of the brain is, up to the present time, very poor. Surgery is unlikely to be curative and the primary goals of the surgery are:(1) to make a histologic diagnosis, (2) to determine the extent of the lesion and (3) if possible, to debulk the tumor. The inclusion of radiation therapy following surgery prolonged median survival time by about 0 weeks as compared to surgery alone or surgery with chemotherapy. 50 patients with anaplastic astrocytoma or glioblastoma multiforme were treated at the Department of Neurosurgery. C.U.M.C. Mar. 1991 and Jul. 1994. All patients were treated with surgical resection, irradiation, chemotherapy with BCNU(1, 3bis(2chloroentlyl) 1nitrosourea), and immunotherapy with interferon beta(IBR therapy). Interferon beta was given in dosages of 100,000~300,000 U for 7 days and BCNU was given in doses of 200mg/sqm for 1 day, intravenously before postoperative radiotherapy and was repeated at the interval of 6 weeks. Survival rates were analyzed between our IBR therapy group and historical data of radiation therapy alone. Several prognostic factors were analyzed in the IBR therapy group. Survival curves were observed according to the Kaplan Meier method. Our observation revealed that IBR therapy showed encouraging results in some patients without stastistical significant in general. However, despite the above observtion, we believe that the statistical out come of the IBR group may change statistically if given a longer follow up period. Furthrmore, our study also demonstrated that the improved survival time gained from total resection over subtotal resection was statistically significant.
Astrocytoma ; Brain ; Carmustine* ; Diagnosis ; Drug Therapy ; Follow-Up Studies ; Glioblastoma ; Glioma* ; Humans ; Immunotherapy ; Interferon-beta* ; Interferons ; Neurosurgery ; Prognosis ; Radiotherapy ; Survival Rate

The treatment outcomes with conventional second-line chemotherapy or radiotherapy aregenerally very poor for patients with relapsed primary CNS lymphoma (PCNSL). We treated three relapsed PCNSL patients with high-dose cytarabine plus etoposide (CYVE) chemotherapy, and this was followed by autologous stem cell transplantation (ASCT). The salvage CYVE chemotherapy consisted of cytarabine 2g/m2/d on days 2 to 5 in a 3-hour infusion and 50mg/m2/d on days 1 to 5 in a 12-hourinfusion, and etoposide 200mg/m2/d on days 2 to 5 in a 2-hour infusion. After two cycles of CYVE chemotherapy, two patients achieved a complete response (CR), and one patient achieved a partial response (PR). All three patients experienced febrile neutropenia and grade 4 thrombocytopenia with the CYVE chemotherapy. However, the hematologic toxicities were well managed without any complications. The conditioning regimen for ASCT consisted of BCNU 300mg/m2 on day -7, etoposide 100mg/m2 on days -6 to -3, cytarabine 100mg/m2 on days -6 to -3, and cyclophosphamide 35mg/kg on days -6 to -3 (BEAC). After ASCT, the patient who initially showed a PR with CYVE chemotherapy then achieved a CR. At the time of this report, one patient remained alive in CR for 41 months after CYVE chemotherapy. The remaining two patients experienced relapse 5 months and 4 months after ASCT, respectively, and they ultimately died of disease progression 18 months and 8 months after ASCT, respectively. In our cases, the CYVE chemotherapy+ASCT was well tolerated, and this induced the complete disappearance of the tumor, and one patient showed prolonged disease-free survival. CYVE chemotherapy+ASCT could be a treatment option for relapsed PCNSL.
Anemia, Hemolytic, Autoimmune ; Carmustine ; Cyclophosphamide ; Cytarabine* ; Disease Progression ; Disease-Free Survival ; Drug Therapy ; Etoposide* ; Febrile Neutropenia ; Humans ; Lymphoma* ; Radiotherapy ; Recurrence ; Stem Cell Transplantation* ; Stem Cells* ; Thrombocytopenia ; Waldenstrom Macroglobulinemia

BACKGROUND: High-dose chemotherapy is increasingly employed in many refractory malignant diseases. This therapy has been reported to increase response rate and survival benefits but it is also associated with higher treatment-related morbidity and mortality. We evaluated clinical characteristics and course of the pulmonary toxicity following high-dose chemotherapy with peripheral blood stem cell transplantation. METHODS: Ninety-seven patients who had received high-dose chemotherapy with peripheral blood stem cell transplantation were evaluated. Five patients who developed lung lesions which were not related to infection nor primary malignant disease underwent transbronchial lung biopsy. The patients' clinical characteristics, treatments, and prognosis were reviewed retrospectively. RESULTS: Five patients(5.1%) developed idiopathic pneumonia syndrome. The high dose chemotherapy regimens employed were cyclophosphamide, BCNU, and cisplatin in 3 cases, one case of BCNU, etoposide, Ara-C, cyclophosphamide combination, and a regimen consisting of BCNU, etoposide, Ara-C, and melphalan. The total dose of BCNU used was 300-400 mg/m2 and that of cyclophosphsmide was 6,000 mg/m2. All of 5 patients received radiation therapy before this treatment. After an average duration of 14 weeks (4-26 weeks) of high-dose chemotherapy, patients developed cough, dyspnea and fever. The chest X-rays showed bilateral diffuse infiltration in 3 cases and the focal infiltration in the other 2 cases. All the patients received corticosteroid therapy as a treatment for the lung lesions. Two of them progressed to acute respiratory distress syndrome and died. Three patients recovered without residual lung lesion but one of them died of dilated cardiomyopathy. CONCLUSION: High-dose chemotherapy with peripheral blood stem cell transplantation especially which containing BCNU regimen may develop idiopathic pneumonia syndrome related to pulmonary toxicity and corticosteroid therapy may be beneficial in some cases.
Biopsy ; Cardiomyopathy, Dilated ; Carmustine ; Cisplatin ; Cough ; Cyclophosphamide ; Cytarabine ; Drug Therapy* ; Drug-Related Side Effects and Adverse Reactions ; Dyspnea ; Etoposide ; Fever ; Humans ; Lung ; Melphalan ; Mortality ; Peripheral Blood Stem Cell Transplantation* ; Pneumonia ; Prognosis ; Respiratory Distress Syndrome, Adult ; Retrospective Studies ; Thorax