Treatment of malignant gliomas: A new approach

The aim of this study is to describe the authors' experience with intra-art erial ACNU chemotherapy of malignant gliomas. The prognosis of cerebral mal ignant gliomas remains poor, whatever traditional therapy is applied. ACNU is a well tolerated nitrosourea with a strong antimitotic effect on neuroge nic cells both in vitro and in vivo; this drug has enhanced efficacy when u sed at high concentrations, particularly as an intraarterial infusion. Seve nty-six patients have been studied to date, 68 of whom are evaluable; these patients were treated by intra-arterial infusion of ACNU (100 mg/m(2)) eve ry 6 weeks, with a mean of 2.5 courses per patient. The objective response (OR) was 28% and analysis of pretreatment factors revealed that survival wa s influenced by histological grade, other types of therapy applied, and age . In general IAC is well tolerated and the response and survival appear to be better than with systemic chemotherapy.