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Clinical Trial of Bradykinin-enhancing Chemotherapy for a Recurrent Malignant Glioma : A Case Report Takanori INAMURA 1 , Kiyonobu IKEZAKI 1 , Eiko HIROKAWA 1 , Tadao KAWAMURA 1 , Takashi YOSHIURA 2 , Futoshi MIHARA 2 , Masanori SUEYASU 4 , Kazuo IRITA 3 , Shosuke TAKAHASHI 3 , Masashi FUKUI 1 1Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University 2Department of Radiology, Graduate School of Medical Sciences, Kyushu University 3Department of Anesthesiology and Critical Care Medicine, Graduate School of Medical Sciences, Kyushu University 4Department of Hospital Pharmacy, Faculty of Medicine, Kyushu University Keyword: bradykinin , chemotherapy , clinical trial , malignant glioma pp.1107-1113
Published Date 2001/11/10
DOI https://doi.org/10.11477/mf.1436902131
  • Abstract
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Patients with malignant glioma undergo a combined treatment with surgical resection, radiotherapy, andchemotherapy. Although those treatments usually show some restraining effects on the tumor, a relapseoccurs in most of the patients within a few years. We have investigated the feasibility and safety of intra-arterial chemotherapy for malignant brain tumors by enhancing vascular permeability using intra-arterialbradykinin infusion. In 2001, The Committee of Ethics in Kyushu University approved our clinical trial ofthe bradykinin-enhancing chemotherapy for recurrent malignant gliomas. We here report the first case ofour clinical trial. A 31-year-old man, who had undergone surgical resection followed by chemotherapy andirradiation for malignant progression of the left frontal astrocytoma over a period of 2 years, had a relapseof the tumor in the bilateral frontal lobes. After obtaining informed consent, bradykinin and carboplatinwere infused through a microcatheter at the left A 1 portion under general anesthesia. By dose escalation ofbradykinin, the enhanced lesion in the bilateral frontal lobes diminished on magnetic resonance imaging af-ter 3 trials with 3-week intervals, regardless of new lesions outside of the treated area. No neurological orphysiological complication including myelosuppression was noted.

Bradykinin-enhancing chemotherapy appeared to be effective and safe for malignant glioma. Because itwas able to increase drug delivery to the tumor, it was possible to reduce the size of the dose of chemo-therapeutic agent, which resulted in minimum complication.


Copyright © 2001, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院

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