Brain tumor, chemotherapy

Sghirlanzoni A, Silvani A, Scaioli V, Pareyson D, Marchesan R, Boiardi A. Cisplatin neuropathy in brain tumor chemotherapy. Ital J Neurol Sci 1992 13(4) 311-15. 

Cancer chemothCTapeutic agents as a rule poorly penetrate the blood brain barrier. Brain tumors are thus not readily treatable by chemotherapy. Diaziquone (at one time known as AZQ) is an exception to this generalization. Treatment of chloranil (213) with the anion from urethane gives intermediate 214, probably by an addition elimination scheme. Displacement of the remaining halogen with aziridine yields diaziquone (215) [.55J. 

In addition to their inherent self-sustaining properties, brain tumor stem cells may be more resistant to chemotherapy and radiation therapy than other tumor cells. Bao et al. (2006) found glioma stem cells (CD133+) were relatively radioresistant compared to CD133- tumor cells and preferentially activated the DNA damage checkpoint response. This relative resistance to standard treatment approaches of tumor stem cells compared to the majority of other cells within a tumor may underlie our current inability to cure patients with aggressive brain tumors such as glioblastoma. 

Stewart DJ, Grahovac Z, Benoit B, et al. Intracarotid chemotherapy with a combination of l,3-bis(2-chloroethyl)-l-nitrosourea (BCNU), cis-diaminedichloroplatinum (cisplatin), and 4 -0-demethyl-l-0-(4,6-0-2-thenylidene-beta-D-glucopyranosyl)epipodophyllotoxin (VM-26) in the treatmentof primary and metastatic brain tumors. Neurosurgery 1984 15(6) 828-833. 

Lehane DE, Bryan RN, Horowitz B, et al. Intraarterial cis-platinum chemotherapy for patients with primary and metastatic brain tumors. Cancer Drug Deliv 1983 l(l) 69-77. 

Carmustine and lomustine can produce remissions that last from 3 to 6 months in 40 to 50% of patients with primary brain tumors. Both drugs also are used as secondary treatment of Hodgkin s disease and in experimental combination chemotherapy for various types of lung cancer. Other tumors in which remission rates of 10 to 30% have been obtained are non-Hodgkin s lymphomas, multiple myeloma, melanoma, renal cell carcinoma, and colorectal cancer. 

Malignant neoplasms of the nervous system occur with an incidence of 5-6/ 100,000 inhabitants/year [197], Besides meningeomas cerebral gliomas are the most frequent primary brain tumors. Primary treatment comprises surgical resection, irradiation and chemotherapy. However, survival and quality of life are still limited. For the diagnosis and differential diagnosis of brain tumors. 

Doolittle, N.D., Miner, M.E., Hall, W.A., Siegal, T., Jerome, E., Osztie, E., McAllister, L.D., Bubalo, J.S., Kraemer, D.F., Fortin, D., Nixon, R., Muldoon, L.L., and Neuwelt, E.A. (2000) Safety and efficacy of a multicenter study using intraarterial chemotherapy in conjunction with osmotic opening of the blood-brain barrier for the treatment of patients with malignant brain tumors. Cancer 88, 637-647. 

F]fluoro-2 -deoxyuridine, [18F]FdUrd, 334, used in tumor chemotherapy and detection of tumors in human brain and lung, is produced for routine clinical use in a microcomputer-controlled process consisting of addition of 18F2 to 3, 5 -di-0-acetyl-2 -deoxyuridine 335, hydrolysis and elimination of AcOH from the 18F-triacetate 336 and chromatographic purification of [18F]FdUrd in tandem columns of ion retardation resin and alumina (equation 143)322. (The mechanism of elimation of AcOH from the 18F-adduct 336 has not been studied.)... 

Moreover, Fiorillo et al. [393] studied the effect of a combination of liposomal daunorubicin, etoposide, and carboplatin administered to seven children with recurrent malignant supratentorial brain tumors as a second-line therapy. Chemotherapy consisted of infusion of liposomal daunorubicin on days 1 and 2 and infusion of etoposide and carboplatin on day 1 whereas courses were repeated every 3M weeks. After a total of eight courses, five of seven children evaluated were alive 12-64 months after diagnosis and 8-29 months from the start of the second-line chemotherapy. Of the seven children, three showed complete response, two partial responses, one stable disease, and one progressive disease. The time to the best response was 3-10 months, while the median time to progression was 23 months. The toxicity observed was minimum. 

Fiorillo, A., Maggi, G., Greco, N., Migliorati, R., D Amico, A., Del Basso De Caro, M., Sabbatino, M. S., and Buffardi,F. (2004), Second-line chemotherapy with the association of liposomal daunorubicin, carboplatin and etoposide in children with recurrent malignant brain tumors,/. Neuro-Oncol., 66,179-185. 

Intra-arterial injection is used to deliver drugs directly to organs, for example, in cancer chemotherapy, and in the use of vasopressin for GI bleeding. Intra-arterial carmustine is effective to treat brain tumors and pelvic intra-arterial actinomycin D is used for malignant trophoblastic disease. ... 

Clayton PE, Shalet SM, Price DA, Campbell RH. Testicular damage after chemotherapy for childhood brain tumors. J Pediatr 1988 112(6) 922-6. 

Peroxide may be the greatest breakthrough we ve ever had for brain tumors. Surgery destroys brain tissue, and chemotherapy for brain neoplasms is just plain quackery. Neuroblastoma cells, a virulent brain cancer, were inhibited by H202 in lab experiments.3... 

Brem H, Piantadosi S, Burger PC, et al. Placebo-controlled trial of safety and efficacy of intraoperative controlled delivery by biodegradable polymers of chemotherapy for recurrent gliomas. The Polymer-brain Tumor Treatment Group. Lancet 1995 345 1008-1012. 

The goal of CNS prophylaxis is to eradicate undetectable leukemic cells from the CNS. Leukemic meningitis is more easily prevented than treated. Once CNS relapse has occnrred, patients are at increased risk of bone marrow relapse and death from refractory leukemia. Initial trials in childhood ALL in the 1960s established craniospinal irradiation as the standard for prevention of CNS relapse." However, this approach was associated with long-term seqnelae including neuropsychological deficits, precocious puberty, osteoporosis, thyroid dysfunction, an increased incidence of brain tumors, short stature, and obesity. Subseqnent trials have demonstrated that irradiation may be replaced by freqnent administration of intrathecal chemotherapy in most children with ALL."... 

J.C., Strother, S.C., Alcock, N., and Rotten-berg, D.A. I Njcisplatin PET to assess pharmacokinetics of intra-arterial versus intravenous chemotherapy for malignant brain tumors. J. Nucl. Med., 28 1844-1852, 1987. 

In Chapter 20, titled Alexander s Tumor, a tragic case study is presented about a brain tumor in a young child that was linked to SV40, it being found in the tumor. The traditional chemotherapy treatments were unbearable, and the child died in his mother s arms. 

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