Safety and efficacy of selective and superselective intra-arterial cerebral infusion with blood–brain barrier disruption for glioma: a systematic review and meta-analysis

作者：Christian Candido Ferreira, Márcio Yuri Ferreira, Leonardo Januário Campos Cardoso, João Paulo Liute Scarramal, Allêh Nogueira, Tamika Wong, Sanskruti Bokil, Faith Singh, Sara Massimo, Olivia Albers, Netanel Ben-Shalom, Randy S. D’Amico, David J. Langer, John Andrew Boockvar, Yafell Serulle · 发表于：Journal of NeuroInterventional Surgery · 年份：2025 · DOI：10.1136/jnis-2025-024057 · 被引用次数：3 · 研究领域：Glioma Diagnosis and Treatment、Brain Metastases and Treatment、Angiogenesis and VEGF in Cancer

BACKGROUND: Selective and superselective intra-arterial cerebral infusion (SIACI/SSIACI) delivers chemotherapy directly to tumor-supplying arteries, achieving high local drug levels with reduced systemic toxicity. Often combined with blood-brain barrier disruption (BBBd) to enhance penetration, these methods have been widely studied, yet a comprehensive evidence synthesis is lacking. This study systematically assesses the safety and efficacy of intra-arterial chemotherapy with BBBd for glioma treatment. METHODS: We searched PubMed, Embase, and Web of Science for studies on SIACI with BBBd in glioma patients. Safety outcomes included rates of cases with complications, procedure-related complications (major/minor), stroke, intracranial and intratumoral hemorrhage, and mortality. Efficacy was based on tumor response (complete, partial, stable disease, progression). A subanalysis of SSIACI-only cases was also conducted. RESULTS: Nine studies with 230 glioma patients were included. The pooled rate of cases with complications was 27.1% (95% CI 19.8% to 35.7%), with procedure-related complications occurring in 15.4% (95% CI 6.1% to 24.6%). Major and minor complication rates were 4.3% (95% CI 0.9% to 7.7%) and 9.7% (95% CI 1.0% to 18.7%), respectively. Stroke, intracranial hemorrhage, and intratumoral hemorrhage occurred in 3.1% (95% CI 0% to 6.1%), 0.5% (95% CI 0% to 3.2%), and 0.04% (95% CI 0% to 3%), respectively, with no procedure-related deaths reported. Pooled response rates we...