Twenty-six patients with cerebral
malignant glioma (7 cases of
astrocytoma Grade 3, and 19 of
astrocytoma Grade 4) were treated by intra-arterial and local administration of
MCNU. Nineteen patients were treated in combination with local radiation in a dose of 60 Gy. Intra-arterial administration of
MCNU was performed by
puncture of the ipsilateral common carotid artery and injection of 25mg of
MCNU in 20 ml of physiological saline. Local administration of
MCNU was performed by
puncture of the Ommaya reservoir placed within the cavity after
tumor resection. Objective
tumor regression was observed on computerized tomography (CT) scans after intra-arterial and/or local administration of
MCNU combined with
radiotherapy in three of seven patients who had evaluable enhanced lesions on CT after surgery. It was also observed after
chemotherapy alone in one of three patients with evaluable lesions. The response rate was 42.9% among patients treated with
MCNU in combination with
radiotherapy, and 33.3% in patients treated with
MCNU alone. In two patients, local administration of
MCNU induced
brain edema, which was transient and caused no neurological sequelae. One patient suffered mild
thrombocytopenia after seven intra-arterial doses of
MCNU, however, no myelosuppression requiring administration of gamma-GCSF or
blood transfusions was observed. These findings suggest that intra-arterial and local administration of
MCNU can be expected to serve as effective and non-myelosuppressive
chemotherapy in patients with cerebral
malignant gliomas.