Intraarterial 1,3-bis(2-chloroethyl)-l-nitrosourea chemotherapy for the treatment of malignant gliomas of the brain: A preliminary report

Intra-Arterial Chemotherapy for Malignant Gliomas: A Critical Analysis

“…Although IA nitrosurea derivatives seemed to be promising in the first human studies 63,64 , the enthusiasm decreased in the 1990s due to neurotoxicity in the IA-treated patients. for instance, in 1986, Novel targeted agents such as bevacizumab or cetuximab were recently introduced into clinical practice.…”

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

“…Although IA nitrosurea derivatives seemed to be promising in the first clinical studies,7 8 enthusiasm decreased in the 1990s due to neurotoxicity in patients given IA treatment. Severe leukoencephalopathy and blindness were described,9 and treated patients also had a higher risk of local cerebral necrosis 9 10.…”

Pharmacokinetics of 11C-labelled BCNU and SarCNU in gliomas studied by PET

“…For instance, the clear advantage of increasing the short-term concentration of the drug delivered to the tumor bed by intra-arterial infusion [7][8][9] has been offset in some clinical trials by the complication of blindness [5,32,33], which can be avoided by locating the intracarotid catheter distal to the ophthalmic artery [8,12,23]. Toxic encephalopathy has followed intra-arterial administration of the drug in the same dosage normally given intravenously [4,[32][33][34][35][36] and using 5% dextrose in water as a solvent for BCNU [34].…”

“…For instance, the clear advantage of increasing the short-term concentration of the drug delivered to the tumor bed by intra-arterial infusion [7][8][9] has been offset in some clinical trials by the complication of blindness [5,32,33], which can be avoided by locating the intracarotid catheter distal to the ophthalmic artery [8,12,23]. Toxic encephalopathy has followed intra-arterial administration of the drug in the same dosage normally given intravenously [4,[32][33][34][35][36] and using 5% dextrose in water as a solvent for BCNU [34]. Apparently some clinical centers have used ethanol as a solvent for BCNU [32,33,35,36]; while ethanol may not present any problem with intravenous administration of the drug, it may lead to toxic effects in cerebral blood vessels exposed to a higher intraarterial concentration of the solvent.…”

“…Toxic encephalopathy has followed intra-arterial administration of the drug in the same dosage normally given intravenously [4,[32][33][34][35][36] and using 5% dextrose in water as a solvent for BCNU [34]. Apparently some clinical centers have used ethanol as a solvent for BCNU [32,33,35,36]; while ethanol may not present any problem with intravenous administration of the drug, it may lead to toxic effects in cerebral blood vessels exposed to a higher intraarterial concentration of the solvent. This sideeffect, however, can be reduced by lowering the intra-arterial dosage.…”