Central nervous system leukemia (CNS-L) is a fatal complication with low remission, high relapse and high death rates in leukemia. Because the existence of blood brain barrier (BBB) hinders drug from going into CNS, therefore it is urgent that to develop a new drug delivery system by which drug can highly and effectively go through BBB. Searching home and abroad literatures from December 2012 to February 2014 found a scheme which may effectively treat the CNSL, that is, ultrasonic microbubbles loading Ara-C, which changes the cell membrane permeability and increases the intercellular space by cavitation effect so as to make the Ara-C through the BBB for therapy. This review focuses on the present status of CNSL treatment and the progress of treating CNSL with ultrasonic microbubbles loading drug.
Central Nervous System Neoplasms ; drug therapy ; Drug Delivery Systems ; Humans ; Leukemia ; drug therapy ; Microbubbles

Multiple primary or secondary malignancies after anticancer therapy were recently reported to be increasing in frequency. The authors describe a case of metachronous metastatic pulmonary basaloid carcinoma to the central nervous system that was discovered after chemotherapy and radiation therapy for cervical uterine carcinoma. Two different types of cancer developed within some interval. There's the possibility that a secondary pulmonary neoplasm developed after the chemotherapy and radiotherapy conducted as cervical cancer treatment.
Central Nervous System ; Drug Therapy* ; Lung Neoplasms ; Neoplasm Metastasis* ; Neoplasms, Second Primary ; Radiotherapy ; Uterine Cervical Neoplasms

Central Nervous System ; pathology ; Central Nervous System Neoplasms ; drug therapy ; Child ; Child, Preschool ; Humans ; Methotrexate ; therapeutic use ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; drug therapy

Primary central nervous system lymphoma (PCNSL) is a rare aggressive non-Hodgkin's lymphoma outside the lymph nodes. At present, high-dose chemotherapy based on methotrexate is the standard induction therapy for newly diagnosed PCNSL, but the effective therapy of relapse/refractory and elderly PCNSL is still unclear. With the progress of clinical trials, new drugs and combined treatment method appear constantly, such as rituximab and ibrutinib, the remission rate of refractory and relapsed patients increased, while lenalidomide showed a good activity in the maintenance treatment of elderly patients. This review summarized briefly the recent advances of research on immunocheckpoint inhibitors, immunoregulatory agents, bruton tyrosine kinase (BTK) and PI3K/AKT/mTOR pathway inhibitors.
Aged ; Antineoplastic Combined Chemotherapy Protocols ; Central Nervous System ; Central Nervous System Neoplasms/drug therapy* ; Humans ; Lymphoma, Non-Hodgkin/drug therapy* ; Neoplasm Recurrence, Local ; Phosphatidylinositol 3-Kinases

Primary malignant lymphoma of the central nervous system which is characterized by high radiosensitiveness is rarely reported in the literature. We have experienced a case of recurred cerebellar lymphoma whose criginal site was septal area. Though septal tumor disappeared completely after radiation, a large cerebellar tumor was found 2 years thereafter. After decompressive suboccipital craniectomy and partial tumor removal the patient's general condition improved so secondary radiation and chemotherapy were started. In the course of port-op therapy, the patient abruptly deteriorated and succumbed.
Central Nervous System ; Cerebellar Neoplasms ; Cerebellum* ; Drug Therapy ; Humans ; Lymphoma* ; Septum of Brain

OBJECTIVE: Because of the limited penetration into the central nervous system after systemic administration of numerous therapeutic compounds, intratumoral chemotherapy for brain tumors has also been used. However, the efficacy of intratumoral drug administration is restricted by the poor diffusion of drug through tumor and brain interstitium. In order to enhance the diffusion of chemotherapeutic agent and increase the cytotoxicity with minimal dose, the authors report the results of convection-enhanced delivery(CED) of chemotherapeutic agent to the malignant brain tumor as a method of enhancing cerebral drug delivery. METHODS: Authors used "CADD-Micro(R) ambulatory infusion pump" from Deltec, which can be programmed for continuous infusion. Intratumoral injection of chemotherapeutic drug using the pump was applied to eight patients with glioma and one patient with lymphoma. Surgery was done and tumor was removed as much as possible. The tip of catheter was placed in the center of tumor cavity. Adriamycin (0.16~0.32mg) was put in the reservoir which was connected to the proximal catheter and fixed in the pump device. Twenty-four hours after surgery, Adriamycin was infused. RESULTS: There was no adverse reaction of CED technique. Compared with current delivery techniques, the improvement of survival rate has been observed(5 patients: alive, 3 patients: dead, 1 patient: lost(alive to 5 mo.)). CONCLUSION: CED can be useful method for distributing therapeutic molecules in the interstitial space of tumor and can be utilized for chemotherapeutic agents, immunotoxins, and gene etc..
Brain ; Brain Neoplasms ; Catheters ; Central Nervous System ; Diffusion ; Doxorubicin ; Drug Therapy ; Glioma ; Humans ; Immunotoxins ; Lymphoma ; Survival Rate

Primary spinal cord melanoma is a rare central nervous system malignant tumor. Usually it resembles an intradural extramedullary (IDEM) nerve sheath tumor or melanoma. We experienced a patient with upper thoracic primary IDEM spinal cord melanoma who was diagnosed to be with hydrocephalus and without intracranial lesions. Initial symptoms of the patient were related to the hydrocephalus and the primary spinal cord melanoma was diagnosed eight months later. At the first operation, complete resection was impossible and the patient refused additional radiotherapy or chemotherapy. At 22 months after surgery, the patient revisited our institution with recurrent both leg weakness. Leptomeningeal dissemination was present in the whole spinal cord and only partial resection of tumor was performed. The symptoms slightly improved after surgery. Primary spinal cord melanoma is extremely rare but complete resection and additional radiotherapy or chemotherapy can prolong the disease free interval. Hydrocephalus or signs of increased intracranial pressure may be the diagnostic clue of spinal cord malignancy and progression.
Central Nervous System ; Drug Therapy ; Humans ; Hydrocephalus* ; Intracranial Pressure ; Leg ; Melanoma* ; Radiotherapy ; Spinal Cord Neoplasms ; Spinal Cord* ; Spine*

We have studied 1927 cases of primary tumor patients, who were admitted, managed and registered at Cancer Center of Maryknoll Hospital from Nov. 1985 to Jun. 1988. Of these, 50 cases were metastasized to central nervous systems, and the cases of brain metastases were 31 cases. This report presents an analysis of 31 cases of metastatic brain tumors. The results are as followings: 1) The sexes were represented with 20 males and 11 females. In 20 cases(65%), the metastases occurred between the 6th decade and 7th decade. 2) The most frequent anatomical site of brain metastases was brain parenchyme(67.7%). 3) The most frequent site of primary malignancy was lung(45.2%), and the next order was choriocarcinoma of the uterus. 4) The clinical symptoms and signs of metastatic brain tumors were headache(87%), nausea, vomiting(35.5%) orderly. 5) In C-T scan findings, the metastatic brain tumors presented hyperdense area at 50% of cases before contrast enhancement, and were enhanced nearly almost of cases. 6) In cases which could be treated surgical procedure, radiation and chemotherapy seemed to improve the prognosis.
Brain Neoplasms* ; Brain* ; Central Nervous System ; Choriocarcinoma ; Drug Therapy ; Female ; Humans ; Male ; Nausea ; Neoplasm Metastasis ; Pregnancy ; Prognosis ; Uterus

The authors report on 17 patients having primary central nervous system(CNS) lymphomas between January, 1981 and August, 1992. All patients were treated at Seoul National University Hospital. Only three cases underwent surgery only and fourteen cases underwent surgery and radiation theraphy with or without chemotherapy. There were no immunosuppressive patients. Sixteen patients were analyzed for survival studies, because one case was lost during follow-up. The median survival time(MST) was 26 months and one- and two-year survival rates for the 16 patients were 87.5% and 65.6% respectively. The rate of survival was analyzed according to possible prognostic factors factors;age and sex, multiplicity and location of tumors, preoperative Karnofsky performance score(KPS), pathological subclassification, type of surgery, preoperative steroid therapy, postoperative adjuvant therapy, extent of radiation, chemotherapy and the degree of response to treatment at three months follow-up. Postoperative adjuvant therapy and the degree of response to the treatment correlated with survival. Fourteen patients who underwent postoperative adjuvant therapy had a median survival time of 63 months. The one- and two-year survival rates were 100% and 75% respectively compared to the MST of 1.5 months with survival rates of 0% and 0% retrospectively for the two patients who did not. A higher long term survival rate was observed in the group with better immediate responses. In nine of 16 patients with complete responses, the MST, one-, and two-year survival rates were 63 months, 100%, and 83% respectively. The authors suggest that preoperative application of steroids may be considered in case of clinically suspected primary CNS lymphomas. It is concluded that after obtaining the tissue diagnosis of primary CNS lymphomas, radiotherapy with or without chemotherapy should be performed until the complete response.
Brain Neoplasms ; Central Nervous System* ; Diagnosis ; Drug Therapy ; Follow-Up Studies ; Humans ; Lymphoma ; Radiotherapy ; Retrospective Studies ; Seoul ; Steroids ; Survival Rate*

5-Fluorouracil (5-FU) based chemotherapy has been commonly used to treat metastatic or advanced colon cancer as an adjuvant chemotherapy. Although the side effects of 5-FU such as gastrointestinal problems and neutropenia and thrombocytopenia are common, not many cases of 5-FU related encephalopathy are reported. Hyperammonemic encephalopathy is a rare central nervous system toxicity following 5-FU chemotherapy manifesting as altered mental status with elevated ammonia levels with no radiologic abnormality. We report one case of 5-FU induced hyperammonemic encephalopathy occurring after Folfox4 (oxaliplatin, folinic acid and 5-fluorouracil) chemotherapy in a colon cancer patient who presented with confused mental status soon after the chemotherapy and review the 5-FU related encephalopathy.
Ammonia ; Brain Diseases, Metabolic ; Central Nervous System ; Chemotherapy, Adjuvant ; Colonic Neoplasms ; Drug Therapy* ; Fluorouracil* ; Humans ; Hyperammonemia ; Leucovorin ; Neutropenia ; Thrombocytopenia