caa a22 4500 469116196 CHVBK 20180323133125.0 cr unu---uuuuu 170328e19920101xx s 000 0 eng 10.1007/BF00172455 doi (NATIONALLICENCE)springer-10.1007/BF00172455 Osmotic blood-brain barrier disruption and chemotherapy in the treatment of high grade malignant glioma: patient series and literature review [Elektronische Daten] [Mary Gumerlock, Barbara Belshe, Richard Madsen, Clark Watts] Summary: In the past, chemotherapeutic treatment of patients with high grade malignant gliomas following surgery and radiation has not added significantly to the 12-14 month median survival rate. Over four years, 37 patients with high grade malignant gliomas underwent 246 treatment procedures with a combination of methotrexate, cyclophosphamide, and procarbazine given in association with hyperosmolar mannitol-induced transient breakdown of the blood-brain barrier. These patients have demonstrated a median survivorship of 22 months after considering age, Karnofsky Performance Score, and necrosis by the Cox Proportional Hazards model. The study group had a mean age of 43 years, and mean Karnofsky Performance Score of 67%. Sixty-five percent of the procedures had well-documented barrier disruption. Sixteen percent remained in complete remission while 24 patients (65%) had partial or temporary remission. Progression-free intervals after blood-brain barrier disruption/chemotherapy ranged from 1-47 (mean 15) months. Neurotoxicity has been minimal with one peri-procedural mortality and five patients suffering an increase in neurologic deficit after a procedure. The results of this study are consistent with and further extend the reported literature on this method of brain tumor therapy as described in other centers. Chemotherapy in conjunction with osmotic disruption of the blood-brain barrier may provide the pharmacokinetic advantage sufficient to significantly improve survival in patients with high grade malignant glioma. Kluwer Academic Publishers, 1992 malignant glioma nationallicence chemotherapy nationallicence blood-brain barrier nationallicence brain tumor survival nationallicence Gumerlock Mary Division of Neurosurgery, University of Missouri-Columbia, Health Sciences Center, One Hospital Drive, 65212, Columbia, Missouri, USA aut Belshe Barbara Division of Neurosurgery, University of Missouri-Columbia, Health Sciences Center, One Hospital Drive, 65212, Columbia, Missouri, USA aut Madsen Richard Division of Biostatistics, University of Missouri-Columbia, Health Sciences Center, One Hospital Drive, 65212, Columbia, Missouri, USA aut Watts Clark Division of Neurosurgery, University of Missouri-Columbia, Health Sciences Center, One Hospital Drive, 65212, Columbia, Missouri, USA aut Journal of Neuro-Oncology Kluwer Academic Publishers 12/1(1992-01-01), 33-46 0167-594X 12:1<33 1992 12 11060 https://doi.org/10.1007/BF00172455 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/BF00172455 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Gumerlock Mary Division of Neurosurgery, University of Missouri-Columbia, Health Sciences Center, One Hospital Drive, 65212, Columbia, Missouri, USA aut NATIONALLICENCE 700 1- Belshe Barbara Division of Neurosurgery, University of Missouri-Columbia, Health Sciences Center, One Hospital Drive, 65212, Columbia, Missouri, USA aut NATIONALLICENCE 700 1- Madsen Richard Division of Biostatistics, University of Missouri-Columbia, Health Sciences Center, One Hospital Drive, 65212, Columbia, Missouri, USA aut NATIONALLICENCE 700 1- Watts Clark Division of Neurosurgery, University of Missouri-Columbia, Health Sciences Center, One Hospital Drive, 65212, Columbia, Missouri, USA aut NATIONALLICENCE 773 0- Journal of Neuro-Oncology Kluwer Academic Publishers 12/1(1992-01-01), 33-46 0167-594X 12:1<33 1992 12 11060 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer