Abstract
The authors evaluated the results of a combined chemoradiotherapy with intracarotid administration of neocarzinostatin (NCS) and radiation in a follow-up study of 26 patients with cerebral malignant glioma. The survival rate was 84.6% at 1 year, and 52.4% at 2 years. Computed tomography scans within 3 months after complete application of the protocols showed complete remission, partial response, minor response, no change, and progressive disease in 11.5%, 38.5%, 19.2%, 23.1%, and 7.7% of patients, respectively. Thus, it was effective in 69.2% of patients. Six (33.3%) out of the 18 patients treated more than 3 years before were alive at full scale (100%) of Karnofsky performance status. Intra-arterial NCS administration was especially appropriate to the malignant glioma, which was fed by unilateral internal carotid artery, and showed marked hypervascularity. Since a preliminary experimental study revealed a synergic effect in cytotoxicity of NCS with radiation, NCS was clinically administered through a slow infusion pump during radiation therapy. The most untoward effect of this method was ocular retinopathy. One third of the cases suffered visual impairment during or after the treatment, when the selective catheterization of the internal carotid artery failed to pass the origin of the ophthalmic artery.
NCS seems to be a suitable chemotherapeutic agent for intra-arterial administration, because of the short half-life in the blood (12 seconds), selective cytotoxicity for glioma cells, and increase of the radiation effect. The total dose of NCS should be over 5 mg in order to attain sufficient therapeutic effect.
