Continuous Intratumoral Delivery of Chemotherapeutic Agent by Convection-enhanced Technique: Preliminary Clinical Study.

Song, Yeung Jin; Kim, Ki Uk; Jung, Dong Geun; Choi, Sun Seob; Huh, Gi Yeong; Seo, Su Yeong

Original Article

Journal of Korean Neurosurgical Society 2004;35(3): 240-245.

Yeung Jin Song, Ki Uk Kim, Dong Geun Jung, Sun Seob Choi, Gi Yeong Huh, Su Yeong Seo

¹Department of Neurosurgery, College of Medicine, Dong-A University, Busan, Korea. kukim@donga.ac.kr
²Department of Biomedical Engineering, College of Medicine, Dong-A University, Busan, Korea.
³Department of Diagnostic Radiology, College of Medicine, Dong-A University, Busan, Korea.
⁴Department of Pathology, College of Medicine, Dong-A University, Busan, Korea.
⁵Department of Microbiology, College of Medicine, Dong-A University, Busan, Korea.

ABSTRACT

OBJECTIVE
Because of the limited penetration into the central nervous system after systemic administration of numerous therapeutic compounds, intratumoral chemotherapy for brain tumors has also been used. However, the efficacy of intratumoral drug administration is restricted by the poor diffusion of drug through tumor and brain interstitium. In order to enhance the diffusion of chemotherapeutic agent and increase the cytotoxicity with minimal dose, the authors report the results of convection-enhanced delivery(CED) of chemotherapeutic agent to the malignant brain tumor as a method of enhancing cerebral drug delivery. METHODS: Authors used "CADD-Micro(R) ambulatory infusion pump" from Deltec, which can be programmed for continuous infusion. Intratumoral injection of chemotherapeutic drug using the pump was applied to eight patients with glioma and one patient with lymphoma. Surgery was done and tumor was removed as much as possible. The tip of catheter was placed in the center of tumor cavity. Adriamycin (0.16~0.32mg) was put in the reservoir which was connected to the proximal catheter and fixed in the pump device. Twenty-four hours after surgery, Adriamycin was infused. RESULTS: There was no adverse reaction of CED technique. Compared with current delivery techniques, the improvement of survival rate has been observed(5 patients: alive, 3 patients: dead, 1 patient: lost(alive to 5 mo.)). CONCLUSION: CED can be useful method for distributing therapeutic molecules in the interstitial space of tumor and can be utilized for chemotherapeutic agents, immunotoxins, and gene etc..

Key Words: Malignant glioma; Chemotherapeutic agent; Convection-enhanced delivery(CED)