Sako K, Yonemasu Y, Okazaki S, Hodozuka A, Fujita T, Daita G, Takei H
Department of Neurosurgery, Asahikawa Medical College, Hokkaido.
Neurol Med Chir (Tokyo). 1990 Sep;30(9):685-90. doi: 10.2176/nmc.30.685.
Since 1984, we have treated 11 malignant glioma patients with intracarotid infusion of ACNU [1-(4-amino-2-methyl-5-pyrimidinyl)-methyl-3-(2-chloroethyl)- 3-nitrosourea hydrochloride] in addition to surgical removal and irradiation. We experienced three patients, who showed clinical manifestation of leukoencephalopathy and computed tomographic (CT) findings of diffuse low-density areas in the white matter on the side of ACNU infusion. Two of the three patients showed an additional CT finding of ring enhancement in the temporo-occipital region. The histological diagnosis of the first case was radiation necrosis, while that of the others was recurrent tumor with coagulation necrosis in the surrounding brain. Our experience suggests that intracarotid ACNU infusion increases the hazard of radiation necrosis, and the optimum dose and effective mode of administration should be evaluated.
自1984年以来，我们除手术切除和放疗外，还对11例恶性胶质瘤患者进行了动脉内注射ACNU[1-(4-氨基-2-甲基-5-嘧啶基)-甲基-3-(2-氯乙基)-3-亚硝基脲盐酸盐]治疗。我们遇到3例患者，他们出现了白质脑病的临床表现，并且在ACNU注射侧的白质区域计算机断层扫描（CT）显示弥漫性低密度区。这3例患者中有2例在颞枕区出现了额外的CT环形强化表现。第一例的组织学诊断为放射性坏死，而其他病例的诊断为复发性肿瘤伴周围脑组织凝固性坏死。我们的经验表明，动脉内注射ACNU会增加放射性坏死的风险，应评估最佳剂量和有效的给药方式。
