THE TREATMENT OF MALIGNANT BRAIN TUMORS BY BAR THERAPY Takao HOSHINO 1 1Department of Neurosurgery, Faculty of Medicine, University of Tokyo pp.601-611
Published Date 1968/6/1
DOI https://doi.org/10.11477/mf.1406202390
  • Abstract
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The agent 5-bromo-2'-deoxyuridine (bromouridine or BUdR), which is known to sensitize bacterial or tumor cells to irradiation, could be incorporated into the nuclei of human brain tumor cells cultured by the trypsinization-monolayer method. The BUdR had neither antimetabolic nor cytocidal effect but did increase the radiosensitivity of the cells that took it up. The uptake of BUdR into the tumor cell nuclei in tissue culture was enhanced by addition of a small amount of antimetabolites such as Metho-trexate, 5-FU or FUdR. This fact may be explained by the hypothesis that the antimetabolites inhibited the biosynthesis of thymidine and thus forced divid-ing cells to incorporate the newly arrived thymidine analogue (BUdR) to duplicate their DNA.

Based on these facts, the authors have performed BUdR-Antimetabolite-continuous intra-arterial infu-sion-Radiation therapy (BAR therapy) for malignant brain tumors. The principle of the therapy included administration of BUdR, 600-1000 mg/day with a small amount of antimetabolites (1 to 5 mg of Meth-otrexate or 3 to 5 mg of 5-FU) by means of con-tinuous intra-arterial infusion for a period longer than the estimated generation time of the brain tumor cells (4-7 weeks) and combined irradiation. The au-thors applied this therapy to 42 cases of brain tumors, with excellent results. The cases of the tumors were summarized in Table 1 and the follow-up study of them were shown in Table 2. More than 85% of patients after the therapy are spending useful life and 60% have returned to their previous occupations. The side effects of BUdR have not been significant except the onychomadesis of finger nails. The au-thors belived this therapy is promising in the treat-ment of malignant brain tumors, although final evaluation will need long-term follow-up.

Copyright © 1968, Igaku-Shoin Ltd. All rights reserved.


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