Uluc Kutluay, Ambady Prakash, McIntyre Matthew K, Tabb John Philip, Kersch Cymon N, Nerison Caleb S, Huddleston Amy, Liu Jesse J, Dogan Aclan, Priest Ryan A, Fu Rongwei, Prola Netto Joao, Siler Dominic A, Muldoon Leslie L, Gahramanov Seymur, Neuwelt Edward A
Department of Neurology, Oregon Health & Science University, Portland, Oregon, USA.
Department of Neurosurgery, Oregon Health & Science University, Portland, Oregon, USA.
Neurooncol Adv. 2022 Jun 25;4(1):vdac104. doi: 10.1093/noajnl/vdac104. eCollection 2022 Jan-Dec.
Intra-arterial administration of chemotherapy with or without osmotic blood-brain barrier disruption enhances delivery of therapeutic agents to brain tumors. The aim of this study is to evaluate the safety of these procedures.
Retrospectively collected data from a prospective database of consecutive patients with primary and metastatic brain tumors who received intra-arterial chemotherapy without osmotic blood-brain barrier disruption (IA) or intra-arterial chemotherapy with osmotic blood-brain barrier disruption (IA/OBBBD) at Oregon Health and Science University (OHSU) between December 1997 and November 2018 is reported. Chemotherapy-related complications are detailed per Common Terminology Criteria for Adverse Events (CTCAE) guidelines. Procedure-related complications are grouped as major and minor.
4939 procedures (1102 IA; 3837 IA/OBBBD) were performed on 436 patients with various pathologies (primary central nervous system lymphoma [26.4%], glioblastoma [18.1%], and oligodendroglioma [14.7%]). Major procedure-related complications (IA: 12, 1%; IA/OBBBD: 27, 0.7%; = .292) occurred in 39 procedures including 3 arterial dissections requiring intervention, 21 symptomatic strokes, 3 myocardial infarctions, 6 cervical cord injuries, and 6 deaths within 3 days. Minor procedure-related complications occurred in 330 procedures (IA: 41, 3.7%; IA/OBBBD: 289, 7.5%; = .001). Chemotherapy-related complications with a CTCAE attribution and grade higher than 3 was seen in 359 (82.3%) patients.
We provide safety and tolerability data from the largest cohort of consecutive patients who received IA or IA/OBBBD. Our data demonstrate that IA or IA/OBBBD safely enhance drug delivery to brain tumors and brain around the tumor.
动脉内给予化疗药物，无论是否联合渗透性血脑屏障破坏，均可增强治疗药物向脑肿瘤的递送。本研究旨在评估这些操作的安全性。
报告回顾性收集的来自俄勒冈健康与科学大学（OHSU）1997年12月至2018年11月期间连续接受无渗透性血脑屏障破坏的动脉内化疗（IA）或有渗透性血脑屏障破坏的动脉内化疗（IA/OBBBD）的原发性和转移性脑肿瘤患者前瞻性数据库的数据。化疗相关并发症按照不良事件通用术语标准（CTCAE）指南详细记录。操作相关并发症分为严重和轻微两类。
对436例患有各种病理类型（原发性中枢神经系统淋巴瘤[26.4%]、胶质母细胞瘤[18.1%]和少突胶质细胞瘤[14.7%]）的患者进行了4939次操作（1102次IA；3837次IA/OBBBD）。39次操作发生了严重操作相关并发症（IA组：12次，1%；IA/OBBBD组：27次，0.7%；P = 0.292），包括3例需要干预的动脉夹层、21例有症状性卒中、3例心肌梗死、6例颈髓损伤以及3天内6例死亡。330次操作发生了轻微操作相关并发症（IA组：41次，3.7%；IA/OBBBD组：
