2016 Volume 25 Issue 11 Pages 882-888
Since 2013, BCNU impregnated wafers have been developed for local delivery and approved to treat malignant gliomas in Japan. In this paper, we overviewed the general description, pharmacokinetics, and treatment results of BCNU wafers for malignant gliomas. BCNU wafers are biodegradable wafers containing 7.7 mg of BCNU. Since local recurrence is the most frequent pattern of failure after the Stupp regimen, it was thought that these wafer could be useful for local control of the disease. Through local application of the wafer, a high concentration of BCNU can be delivered to the tumor bed over several weeks as shown in in vitro and in vivo studies. In patients after implantation of the wafer, a high concentration of BCNU was maintained in the cerebrospinal fluid of the resection cavity for a week.
In initially diagnosed cases, the overall survival rate of patients treated with BCNU wafer and the Stupp regimen was slightly longer than that for patients treated with the Stupp regimen alone. However, in recurrent cases, the usefulness of the wafer may not be recognizable. In conclusion, the use of a BCNU wafer in combination with the Stupp regimen may be a viable first-treatment option of malignant gliomas.