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Stereotaxic implantation of 5‐fluorouracil‐releasing microspheres in malignant glioma
Author(s) -
Menei Philippe,
Jadaud Eric,
Faisant Nathalie,
BoisdronCelle Michèle,
Michalak Sophie,
Fournier Dominique,
Delhaye Manuel,
Benoit JeanPierre
Publication year - 2004
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.11922
Subject(s) - medicine , brachytherapy , glioma , microsphere , fluorouracil , magnetic resonance imaging , surgery , stereotaxy , radiosensitizer , radiation therapy , nuclear medicine , radiology , chemotherapy , cancer research , chemical engineering , haptic technology , computer science , engineering , operating system
BACKGROUND The authors developed a new method of drug delivery into the brain using implantable, biodegradable microspheres. The strategy was evaluated initially to provide localized and sustained delivery of the radiosensitizer 5‐fluorouracil (5‐FU) after patients underwent surgical resection of malignant glioma. In this study, the microspheres were implanted by stereotaxy into deeply situated and inoperable brain tumors. METHODS Ten patients with newly diagnosed, inoperable, malignant gliomas were included in the study, and 1 dose of 5‐FU was studied (132 mg). After histologic confirmation, a suspension of poly(D‐L lactide‐co‐glycolide) 5‐FU‐loaded microspheres was implanted by stereotaxy into the tumor in one or several trajectories with one to seven deposits per trajectory. External beam radiation (59.4 grays) was started before postoperative Day 7. Patients were followed by clinical examination, computed tomography scanning, magnetic resonance imaging, and 5‐FU assays in blood and cerebrospinal fluid (CSF). RESULTS The number of trajectories was adapted to the size and shape of the tumor. Microsphere implantation was tolerated well, except in four patients who received a single trajectory and experienced a transitory worsening of preexisting neurologic symptoms. There were no episodes of edema or hematologic complications. 5‐FU was detected in CSF and blood in some patients at very low concentrations. The median overall survival was 40 weeks, with 2 patients who had longer survival (71 weeks and 89 weeks, respectively). CONCLUSIONS In this study, the authors demonstrated that biodegradable microspheres could be implanted by stereotaxy and were efficient systems for drug delivery into brain tumors. This method may have future applications in the treatment of patients other malignancies. Cancer 2004;100:405–10. © 2003 American Cancer Society.