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Intraarterial mitomycin-C for recurrent brain metastases.

D J Stewart¹, Z Grahovac, H Hugenholtz

¹Ontario Cancer Treatment and Research Foundation, Ottawa, Canada.

American Journal of Clinical Oncology

|October 1, 1987

Summary

Intraarterial mitomycin-C shows promise for recurrent brain metastases after cranial irradiation. This treatment offers a 46% response rate with manageable toxicity, providing a viable option for patients who have exhausted standard therapies.

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Area of Science:

Neuro-oncology
Medical Oncology
Interventional Radiology

Background:

Brain metastases are a common complication of systemic cancers.
Recurrent brain metastases after cranial irradiation present a significant treatment challenge.
Limited effective therapeutic options exist for patients with progressive disease post-irradiation.

Purpose of the Study:

To evaluate the efficacy and safety of intraarterial mitomycin-C for patients with recurrent brain metastases.
To determine response rates, duration of response, and overall survival.
To assess treatment-related toxicity and identify dose-limiting factors.

Main Methods:

Fifteen patients with recurrent brain metastases received intraarterial mitomycin-C (15 mg/m2) via transfemoral catheter.

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Treatment was administered in 100 ml 0.45% saline over 20 minutes with an in-line filter.

Patient response was assessed using computed tomography (CT) scans and neurological evaluations.

Main Results:

Six out of 13 evaluable patients (46%) demonstrated a response, evidenced by both CT scan and neurological improvement.
Median duration of response was 25 weeks.
Median survival for all 15 patients was 17 weeks, with dose-limiting toxicities including neurological, ocular, and local skin effects.

Conclusions:

Intraarterial mitomycin-C is an effective and reasonably well-tolerated regimen for recurrent brain metastases post-cranial irradiation.
Toxicity appears comparable to other intra-arterial regimens and potentially less toxic via vertebral artery infusion.
This treatment is not recommended as first-line therapy but serves as a valuable option for refractory disease.