Intra-arterial ACNU and cisplatin chemotherapy for the treatment of glioblastoma multiforme.

Intra-arterial (IA) chemotherapy has achieved no obvious clinical superiority as a treatment for glioblastoma multiforme despite the many theoretical advantages. The clinical courses of 38 patients who underwent surgery and radiotherapy with IA 1-(4-amino-2-methyl-5-pyrimidinyl)-methyl-3-(2-chloroethyl)-3-nitrosourea hydrochloride (ACNU) and cisplatin were reviewed. Tumor regrowth was evaluated by comparison of contrast-enhanced areas on computed tomographic scans. The initial response rate was 19 of 32 patients evaluated, and the median survival time (MST) for all 38 patients was 53 weeks. Local recurrence was observed in 20 patients, and distant recurrence (areas more than 3 cm from the original tumor margin) was observed in 15 patients. The MST was 59 weeks for patients without distant recurrence, and 42 weeks for patients with distant recurrence (statistically not significant). Adjuvant IA ACNU and cisplatin chemotherapy did not improve the survival time. An important clinical feature was the high incidence of distant recurrence, in contrast to experience with other conventional therapy regimens. Distant recurrence, without extended survival, may suggest insufficient control of tumor regrowth.