Safety of intra-arterial chemotherapy with or without osmotic blood–brain barrier disruption for the treatment of patients with brain tumors

作者：Kutluay Uluç, Prakash Ambady, Matthew K. McIntyre, John Philip Tabb, Cymon N. Kersch, Caleb S. Nerison, Amy E. Huddleston, Jesse J. Liu, Aclan Dog⫧an, Ryan A. Priest, Rongwei F. Fu, João Prola Netto, Dominic A. Siler, Leslie L. Muldoon, Seymur Gahramanov, Edward A. Neuwelt · 发表于：Neuro-Oncology Advances · 年份：2022 · DOI：10.1093/noajnl/vdac104 · 被引用次数：25 · 研究领域：Brain Metastases and Treatment、Nanoplatforms for cancer theranostics、Lung Cancer Research Studies

Abstract Background Intra-arterial administration of chemotherapy with or without osmotic blood–brain barrier disruption enhances delivery of therapeutic agents to brain tumors. The aim of this study is to evaluate the safety of these procedures. Methods Retrospectively collected data from a prospective database of consecutive patients with primary and metastatic brain tumors who received intra-arterial chemotherapy without osmotic blood–brain barrier disruption (IA) or intra-arterial chemotherapy with osmotic blood–brain barrier disruption (IA/OBBBD) at Oregon Health and Science University (OHSU) between December 1997 and November 2018 is reported. Chemotherapy-related complications are detailed per Common Terminology Criteria for Adverse Events (CTCAE) guidelines. Procedure-related complications are grouped as major and minor. Results 4939 procedures (1102 IA; 3837 IA/OBBBD) were performed on 436 patients with various pathologies (primary central nervous system lymphoma [26.4%], glioblastoma [18.1%], and oligodendroglioma [14.7%]). Major procedure-related complications (IA: 12, 1%; IA/OBBBD: 27, 0.7%; P = .292) occurred in 39 procedures including 3 arterial dissections requiring intervention, 21 symptomatic strokes, 3 myocardial infarctions, 6 cervical cord injuries, and 6 deaths within 3 days. Minor procedure-related complications occurred in 330 procedures (IA: 41, 3.7%; IA/OBBBD: 289, 7.5%; P = .001). Chemotherapy-related complications with a CTCAE attribution and grade ...