Central nervous system brain tumors

The study of the Central Nervous System (CNS) is the primary clinical indication for the use of extracellular Gd(III) agents. The majority of these pathologies are brain tumors, and three quarters of them are represented by metastases occurring in patients undergoing treatment for systemic cancer (Fig. 1). Other brain diseases, such as multiple sclerosis and cerebral injuries can be also investigated by contrast-enhanced MRI. 

Stewart DJ, Leavens M, Maor M, et al. Human central nervous system distribution of cis-diamminedichloroplatinum and use as a radiosensitizer in malignant brain tumors. Cancer Res 1982 42 2474-2479. 

Glantz MJ, Choy H, Kearns CM, et al. Paclitaxel disposition in plasma and central nervous systems of humans and rats with brain tumors. J Natl Cancer Inst 1995 87(14) 1077-1081. 

Head trauma, meningitis, childhood fevers, brain tumors, and degenerative diseases of the cerebral circulation are conditions often associated with the appearance of recurrent seizures that may require treatment with anticonvulsant drugs. Seizures also may be a toxic manifestation of the action of central nervous system (CNS) stimulants and certain other drugs. Seizures often occur in hyperthermia (febrile seizures are very common in infants) sometimes in eclampsia, uremia, hypoglycemia, or pyridoxine deficiency and frequently as a part of the abstinence syn-... 

Procarbazine Methylates DNA and inhibits DNA synthesis and function Flodgkin s and non-Flodgkin s lymphoma, brain tumors Central nervous system depression Myelosuppression, hypersensitivity reactions... 

Robbiano, L. Brambilla, M. (1987) DNA damage in the central nervous system of rats after in vivo exposure to chemical carcinogens correlation with the induction of brain tumors. Teratog. Carcinog. Mutag.. 7, 175-181... 

PERC is metabolized to trichloroacetic acid and other trichloro metabolites in the liver. Trichloroacetic acid has been shown to produce peroxisome proliferation in mice. This may have implications for the apparent increase in liver tumors in mice. PERC also has been shown to distribute rapidly to the central nervous system (CNS) and is known to have an affinity for the lipophilic cellular membranes in the brain. 

Also, hCG is useful in identifying patients with trophoblastic tumors and, together with AFP, in detecting non-seminomatous testicular tumors. Levels of hCG correlate with the tumor volume and disease prognosis. The presence of hCG in seminoma may indicate the presence of choriocarcinoma. Because hCG does not cross the blood-brain barrier, the normal cerebrospinal fluid-to-serum ratio is 1 60. Higher levels in cerebrospinal fluid may indicate metastases to the brain. Furthermore, the response to therapy for patients with central nervous system metastasis may be indicated by monitoring the hCG level. 

EPO may also act to facilitate the survival and proliferation of nonerythroid cells as well. In addition to production in the kidneys, EPO is produced in the brain, although this form has a lower molecular weight than the peripherally produced variant (89). In the central nervous system (CNS), EPO plays a critical role in brain function and development. EPO receptors have also been isolated in ovary, oviduct, uterine, and testes cells (90), as well as some tumor cell lines such as breast cancer (91). The function of EPO binding in these alternate cell types has not yet been determined, although the appearance of EPO receptors on cancer cells has been indicated as a poor prognosis factor (92). The use of EPO to treat anemia arising from chemotherapy or from cancer has therefore been called into question (93). 

Green and Robinson109 pointed out that sulfatides are present not only in the tissue of the central-nervous system, but also in other organs, namely, kidney, liver, and spleen (and in mast-cell tumor). From the point of view of physiology, a noteworthy characteristic of the sulfatides is the extremely slow turnover in the brain, in contrast to that in the other organs. Also, they accumulate continuously in the brain. 

Because of their highly lipophilic nature, nitrosoureas are particularly useful against malignancies of the central nervous system such as brain tumors (gliomas), where response rates have exceeded 40%. They are also used (in combination therapy) against multiple myeloma, Hodgkin s disease, and non-Hodgkin s lymphoma. 

A Bone marrow suppression (nadir at 4-6 weeks), pulmonary toxicity. IV. Short half life, crosses blood brain barrier. Central nervous system tumors, melanoma, and lymphomas. Most toxic alkylating agent. 

Yu JS. Phase II Trial of Tumor Lysate-Pulsed Dendritic Cell Immunotherapy for Patients With Atypical or Malignant, Primary or Metastatic Brain Tumors of the Central Nervous System, 2001. 

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