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Japanese Journal of Clinical Oncology 31:251-258 (2001)
© 2001 Foundation for Promotion of Cancer Research

Intracavitary Chemotherapy with 5-Fluoro-2'-deoxyuridine (FdUrd) in Malignant Brain Tumors

Hidemitsu Nakagawa, Nobuhiko Maeda, Takashi Tsuzuki, Tsuyoshi Suzuki, Azuma Hirayama, Eiji Miyahara and Kouichi Wada+

Department of Neurosurgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan

Background: After completing basic research on the anti-tumor effects and neurotoxicity of 5-fluoro-2'-deoxyuridine (FdUrd) and the balance of thymidine kinase and thymidine phosphorylase activities and confirming the safety of intrathecal FdUrd administration in a previous clinical study of meningeal carcinomatosis, intracavitary administration of FdUrd was performed as a second trial in patients with malignant glioma and metastatic brain tumors.

Methods: The study population consisted of 13 patients, six with glioblastoma, one with anaplastic astrocytoma and six with metastatic brain tumors. This treatment was applied for cystic, small-volume residual or recurrent tumors. FdUrd (1–10 µg ) was administered every day at least 25 times through an Ommaya device placed in the cyst or closed postoperative cavity reconstructed with a patch of galea aponeurotica. Intracavitary chemotherapy with FdUrd was preceded by radiation therapy in two patients but no other adjuvant therapy was performed.

Results: No side effects such as headache, nuchal pain, convulsive attack, bone marrow suppression or liver dysfunction were observed during the course of chemotherapy. Seven of the 13 patients showed responses: complete response six, minor response one, no change two and progressive disease four after the twenty-fifth intracavitary administration of FdUrd when tumor sizes on CT scans and MRI before and after intracavitary chemotherapy were compared.

Conclusions: Intracavitary FdUrd chemotherapy may be useful for the treatment of small-volume tumors.

+ For reprints and all correspondence: Hidemitsu Nakagawa, Department of Neurosurgery, Osaka Medical Center for Cancer and Cardiovascular Diseases (OMCC), 3 Nakamichi l-chome, Higashinari-ku, Osaka 537-8511, Japan. E-mail: hidemitu@osaka.macnet.or.jp


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