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

No abstract available
Drug Therapy ; Glioma* ; Humans ; Nimustine* ; Radiotherapy*

No abstract available.
Astrocytoma ; Brain* ; Drug Therapy ; Glioblastoma ; Glioma* ; Humans ; Nimustine* ; Radiotherapy*

In order to determine if there was an enhancing therapeutic effect of ACNU(1-4-amino-2-methyl-5-pyrimidinyl)-methyl-3-(2-chloroethyl)-3-nitrosourea hydrochloride, nimustine chloride given in addition to radiotherapy, we performed a randomized clinical study of irradiation alone and combination of irradiation with ACNU in the treatment of malignant gliomas. Thirty-seven patients who were treated in our hospital from August 1990 to September 1992 were included in this study. An effect was defined as a statistically improved survival times. Radiotherpy with a total dose of 5000 to 6500 rads was applied to the whole brain and to a generous field surrounding the tumor. Patients who were assigned to receive chemotherapy were given ACNU intravenously at a dose of 1-2mg/kg. The survival rates of patients with anaplastic astrocytoma and glioblastoma multiforme at 18 months after the surgery were 0% and 37% for radiotherapy alone, and 66.7% and 40.1% for radiotherapy plus ACNU, respectively. The median survival times of patients with anaplastic astrocytoma and glioblastoma multiforme were 14 and 15 months for radiotherapy alone, and 19 and 16 months for radiotherapy plus ACNU, respectively. The survival rates of patients with malignant gliomas(anaplastic astrocytoma plus glioblastoma multiforme) at 18 months were 5.5% for radiotherapy alone and 45.4% for radiotherapy plus ACNU, and the median survival times were 15 and 16 months, respectively, Althouh the survival rate of patients with malignant gliomas at initial 6 months was much higher in radiotherapy plus ACNU than in radiotherapy alone, the differences between survival curves were not significant at the p=0.05 level. This study demonstrated that, although the use of ACNU during radiotherapy suppressed malignant gliomas more than radiotherapy alone, the survival time was not extended significantly. It is necessary to continue to search for an effective chemotherapapeutic regimen to prolong survival of patients with malignant gliomas.
Astrocytoma ; Brain ; Drug Therapy* ; Glioblastoma ; Glioma* ; Humans ; Nimustine* ; Radiotherapy ; Survival Rate

Six patients with medulloblastoma involving brain stem were treated with surgical excision, irradiation or chemotherapy consisting of ACNU, vincristine and procarbazine from 1982 to 1993. All 6 patients were treated by surgical excision. Chang's staging was from T3b to T4 and radiation therapy was done in 5 patients and chemotherapy was performed in 4 patients. Mena follow up period was 25 months(range 1 to 87 months). The result of treatment for medulloblastomas invading brain stem was unfavorable in general, but radiation therapy combined aggressive chemotherapy after surgical resection could show a good result in some cases.
Brain Stem ; Brain* ; Drug Therapy ; Follow-Up Studies ; Humans ; Medulloblastoma* ; Nimustine ; Procarbazine ; Vincristine

OBJECTIVE: Anti-malaria drugs may modulate tumor resistance to chemotherapeutic agents, but it has not been proven effective in the treatment of malignant gliomas. The aim of this study was to determine whether adequate pre-clinical data on co-administration of chemotherapeutic agents with anti-malaria drugs on malignant cell lines could be obtained that would warrant its further potential consideration for use in a clinical trial for malignant gliomas. METHODS: Two malignant glioma cell lines (U87MG, T98G) were treated with chemotherapeutic agents alone or with anti-malaria drugs. Cells were incubated with drugs for 4 days. Following the 4-day incubation, drug sensitivity assays were performed using 3-(4, 5-dimethyl-2-thiazol-2-yl) 2, 5-diphenyltetrazolium bromide (MTT) assay following optimization of experimental conditions for each cell lines and cell viability was calculated. RESULTS: In all of four chemotherapeutic agents(doxorubicin, vincrisitne, nimustine, and cisplatin), the cell viability was found to be markedly decreased when hydroxychloroquine was co-administered on both U87MG and T98G cell lines. The two way analysis of variance(ANOVA) yielded a statistically significant two-sided p-value of 0.0033(doxorubicin), 0.0005(vincrisitne), 0.0007(nimustine), and 0.0003(cisplatin) on U87MG cell lines and 0.0006(doxorubicin), 0.0421(vincrisitne), 0.0317(nimustine), and 0.0001(cisplatin) on T98G cell lines, respectively. However, treatment with chloroquine and primaquine did not induce a decrease in cell viability on both U87MG and T98G cell lines. CONCLUSION: Our data support further consideration of the use of hydroxychloroquine prior to systemic chemotherapy to maximize its tumoricidal effect for patients with malignant gliomas.
Cell Line* ; Cell Survival ; Chloroquine ; Drug Resistance, Multiple ; Drug Therapy ; Glioma* ; Humans ; Hydroxychloroquine* ; Nimustine ; Primaquine

Posterior leukoencephalopathy syndrome(PLES) is a rare neurological complication which is associated with malignant hypertension, pre-eclampsia, and some drugs including immunosuppressive agents. A 9-year-old boy who had cerebellar medulloblastoma showed seizure on the seventeenth day after intravenous chemotherapy including ACNU and vincristine. Radiologic findings were consistent with those of PLES due to vasospasm. After hypertensive therapy, the symptoms were improved. We present a case of PLES with medulloblastoma which developed following chemotherapy with the regimen of medulloblastoma in a child.
Child* ; Drug Therapy* ; Humans ; Hypertension, Malignant ; Immunosuppressive Agents ; Leukoencephalopathies ; Male ; Medulloblastoma* ; Nimustine ; Posterior Leukoencephalopathy Syndrome* ; Pre-Eclampsia ; Seizures ; Vincristine

PURPOSE: To report the result of combined chemotherapy and radiotherapy for 5 retinoblastoma patients. METHODS: Retrospective study of 5 patients (8 eyes) who were diagnosed with retinoblastoma of group III to V in the Reese-Ellsworth (R-E) classification was done. After 6 cycles of chemotherapy consisting of Vincristine, VP-16 (Etoposide) and Carboplatin, Radiotherapy (4500Gy/5weeks) was done. Neoaedjuvant therapy consisting of Nimustine and Carboplatin was done, and supplementary laser photocoagulation was done in 1 case. Mean follow-up period is 33 months. RESULTS: Significant reduction of tumor size and regression were observed in five eyes of R-E classification group V, and slight reduction of tumor size and regression were observed in three eyes of R-E classification groups III and IV. There was no recurrence and no new mass was detected. CONCLUSIONS: Combined chemotherapy, radiotherapy and supplementary therapy may save eyeballs which were diagnosed with retinoblastoma, even R-E classification group V.
Carboplatin ; Classification ; Drug Therapy* ; Etoposide ; Follow-Up Studies ; Humans ; Light Coagulation ; Nimustine ; Radiotherapy* ; Recurrence ; Retinoblastoma* ; Retrospective Studies ; Vincristine

OBJECTIVE: This study is aimed at evaluating the efficacy and the toxicity of a 72-hour continuous intravenous infusion of ACNU and CDDP before radiotherapy in adult patients with newly diagnosed anaplastic astrocytoma and glioblastoma. METHODS: Forty-three adult patients with a postoperative Karnofsky performance status greater than 60 were entered into this protocol without any prior treatment. Two cycles of preradiation chemotherapy were performed at 6-week intervals. Conventional radiotherapy was begun 6 weeks later. Magnetic resonance (MR) imaging studies were conducted pre- and postoperatively, and follow-up MR images at the beginning of each treatment and every three months after radiotherapy completion. Response rate, survival rate, prognostic factors and complications were evaluated. RESULTS: Among 43 patients mentioned above, twenty-one patients completed two cycles of chemotherapy. One patient showed complete remission, ten partial response, seven stable disease and three progressive disease. The median survival time was 15.9 months. Overall response rate was 22.3%. Twenty-seven showed pancytopenia, including two bleeding tendencies, one intracerebral hemorrhage resulting to death, and another two infections. Considering the prognostic factors, only a mutated p53 level of under 20%(% of tumor cells containing mutated p53) was correlated with survival prolongation. Prognostic factor of age under 45 was the only significant factor of extending the time to progression. CONCLUSION: This treatment protocol shows favorable results of preradiation chemotherapy using ACNU and CDDP.
Adult ; Astrocytoma* ; Cerebral Hemorrhage ; Clinical Protocols ; Drug Therapy ; Follow-Up Studies ; Glioblastoma ; Hemorrhage ; Humans ; Infusions, Intravenous ; Karnofsky Performance Status ; Nimustine* ; Pancytopenia ; Radiotherapy* ; Survival Rate

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