Intraarterial chemotherapy for brain tumors by using a spatial dose fractionation algorithm and pulsatile delivery.
Radiology
; 218(3): 724-32, 2001 Mar.
Article
en En
| MEDLINE
| ID: mdl-11230646
PURPOSE: To evaluate the cause of complications in intraarterial chemotherapy for brain tumors and validate a dosage algorithm based on arterial territory. MATERIALS AND METHODS: Four hundred sixty-two procedures were performed in 113 patients. Technique included pulsatile infusion of a chemotherapeutic agent. Dosage was calculated per hemisphere and divided per arterial territory according to a spatial dose fractionation algorithm based on the vascular territories of major cerebral arteries: middle cerebral artery, 60%; anterior cerebral artery, 20%; posterior cerebral artery, 15%; and perforator arteries, 5%. Hospital charts of all patients were retrospectively reviewed for complications, with specific attention given to the angiograms to determine a cause. Then, subgroup analysis of the chemotherapy protocol with the largest patient population was performed to evaluate predictors of complications. RESULTS: Six (1.3%) complications were asymptomatic; 12 (2.6%), transient neurologic; three (0.6%), permanent minor neurologic; three (0.6%), permanent major neurologic; and 32 (7.0%), seizures. In the subgroup analysis, the hemispheric dose administered according to the algorithm was strongly predictive of seizure and neurologic deficit. CONCLUSION: Neurotoxicity of intraarterial cerebral chemotherapy can be minimized by using pulsatile injection and the described spatial dose fractionation algorithm.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Neoplasias Encefálicas
/
Infusiones Intraarteriales
Tipo de estudio:
Prognostic_studies
Límite:
Adolescent
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Adult
/
Aged
/
Child
/
Child, preschool
/
Female
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Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Radiology
Año:
2001
Tipo del documento:
Article
País de afiliación:
Estados Unidos
Pais de publicación:
Estados Unidos