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CC BY-NC-ND 4.0 · Asian J Neurosurg 2018; 13(04): 1171-1174
DOI: 10.4103/ajns.AJNS_235_16
Case Report

Adverse event with the use of carmustine wafers and postoperative radiochemotherapy for the treatment of high-grade glioma

Federico Salle
1   Department of Neurosurgery, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Henri-Mondor Albert-Chenevier, PePsy Department
2   U955 INSERM IMRB eq. 14 Université Paris 12 UPEC, Faculté de Médecine, F-94010 Créteil, France
3   Department of Neurosurgery, Hospital Maciel-ASSE, Montevideo, Uruguay
,
Wissem Lahiani
1   Department of Neurosurgery, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Henri-Mondor Albert-Chenevier, PePsy Department
,
Edgardo Spagnuolo
3   Department of Neurosurgery, Hospital Maciel-ASSE, Montevideo, Uruguay
,
Stéphane Palfi
1   Department of Neurosurgery, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Henri-Mondor Albert-Chenevier, PePsy Department
2   U955 INSERM IMRB eq. 14 Université Paris 12 UPEC, Faculté de Médecine, F-94010 Créteil, France
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Randomized, controlled trials have shown significant improvement of survival after implantation of 1,3-bis(2-Chloroethyl)-1-nitrosourea (BCNU) wafers for patients suffering from high-grade glioma. A combination of local chemotherapy with BCNU and concomitant radiochemotherapy with temozolomide (TMZ) appears to be attractive to enhance the overall survival, even though these treatments may potentially cumulate their toxicity.We report a clinical case of a patient submitted to this combined treatment protocol. Severe brain edema and a cystic formation in the surgical cavity rapidly developed. Data supporting the use of Gliadel® combined with TMZ comes from small retrospective studies, and some series have shown a very high rate of adverse events (AEs) when this multimodality treatment is applied. Combined protocols of local and systemic chemotherapy might provide survival benefits, although AEs seem currently underestimated.

Key-words:

Adverse events - carmustine wafers - Gliadel - high-grade glioma


Publication History

Article published online:
14 September 2022

© 2018. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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