ENHANCEMENT OF ACNU TREATMENT OF THE BT(4)AN RAT GLIOMA BY LOCAL BRAIN HYPERTHERMIA AND INTRAARTERIAL DRUG ADMINISTRATION

To evaluate the role of intra-arterial (i.a.) chemotherapy, intravenou s (i.v.) chemotherapy, and local brain hyperthermia in the treatment o f gliomas, the effect of i.v. versus i.a. drug delivery, with or witho ut local brain hyperthermia, was evaluated in ED IX rats with BT,An gl iomas implanted in the right frontal lobe. The rats were given ACNU 18 mg/kg i.a. in the right carotid artery or i.v. in the inferior cava w ith or without local microwave hyperthermia at 42.4 degrees C for 45 m in. ACNU i.v. alone had no notable effect on survival. Survival was pr olonged when ACNU without hyperthermia was given i.a. instead of i.v. (P < 0.05). Thermochemotherapy with ACNU i.a. was more effective than with ACNU i.v. (P < 0.01). Survival improved as hyperthermia enhanced the i.v. drug effect (P < 0.01), and hyperthermia also improved the i. a. ACNU effect (P < 0.01). Post-treatment survival was more than doubl ed for the group given combined i.a. ACNU and hyperthermia, compared t o controls. Thermochemotherapy, particularly with i.a. drug administra tion, seems to be a promising new approach for the treatment of primar y brain tumours. However, more knowledge about tolerance of human brai n tissue to hyperthermia is necessary before this treatment modality i s used in patients with a reasonable life expectancy.