OPENING BLOOD-BRAIN-BARRIER BY INTRACAROTID INFUSION OF PAPAVERINE INTREATMENT OF MALIGNANT CEREBRAL GLIOMA

Objective To find an effective method for the treatment of malignant c erebral glioma by opening the blood-brain-barrier (BBB). Methods The c oncentration of methotrexate (MTX) in tumor was measured in 18 patient s with cerebral glioma, and 155 patients with malignant glioma were tr eated by intracarotid infusion of papaverine and Bis-chloronitrosourea (BCNU). Results After intracarotid infusion of papaverine for reversi ble opening of BBB, the MTX concentration in tumor tissue was 1810 +/- 380 ng/g, higher than that in patients without papaverine infusion (9 97 +/- 126 ng/g). Eighty-nine patients with glioblastoma and 66 patien ts with anaplastic astrocytoma received intracarotid infusion of papav erine and BCNU (250 mg) for an average of 2, 14 times. The mean surviv al time of these patients was 114.5 weeks, median survival time was 14 0 weeks, and five-year survival rate was 22.97%. Conclusion The combin ed chemotherapy with papaverine and BCNU through intra-arterial infusi on is simple, safe and effective in treating malignant cerebral glioma so long as the tumor is sensitive to the drugs.