Mortimer J E, Hewlett J S, Bay J, Livingston R B
J Neurooncol. 1983;1(3):269-73. doi: 10.1007/BF00165611.
Eleven patients with malignant gliomas recurring after surgery and radiation therapy, were treated with high dose BCNU 1 050-1 200 mg/M2 with autologous bone marrow rescue. Four patients also received concomitant 5-fluorouracil 1 000 mg/M2/24 hr daily for three days. Eight of ten evaluable patients demonstrated improvement on CAT scan as well as a decrease in steroid requirement. All patients surviving longer than two weeks after BCNU administration experienced full hematologic recovery. No delayed myelosuppression was seen after a single course of high dose therapy. Two patients died as a result of therapy, one following a second induction of BCNU for a total cumulative BCNU dose of 2 400 mg/M2 and one of infection while cytopenic. Additional toxicity includes one steroid-responsive interstitial pneumonitis, one centrilobular necrosis of the liver which spontaneously resolved and one episode of deep vein thrombosis. With limitation on the maximum BCNU dose and distribution of the total dose over three days, high dose BCNU can be administered with acceptable toxicity. This approach may offer a higher response rate than that expected for standard dose BCNU.
11例恶性胶质瘤患者在手术和放疗后复发，接受了大剂量卡氮芥（BCNU）1050 - 1200mg/M²治疗，并进行自体骨髓挽救。4例患者还同时接受了5-氟尿嘧啶1000mg/M²/24小时，持续三天的治疗。10例可评估患者中有8例在CT扫描上显示有改善，且类固醇需求减少。所有在给予BCNU后存活超过两周的患者均实现了完全血液学恢复。单次大剂量治疗后未见延迟性骨髓抑制。2例患者因治疗死亡，1例在第二次诱导使用BCNU后，卡氮芥总累积剂量达到2400mg/M²，另1例在血细胞减少期间死于感染。其他毒性反应包括1例对类固醇有反应的间质性肺炎、1例自发缓解的肝小叶中心坏死以及1次深静脉血栓形成。通过限制BCNU的最大剂量并将总剂量分三天给予，大剂量BCNU可以在可接受的毒性下给药。这种方法可能比标准剂量BCNU预期的反应率更高。
