[New management of brain neoplasms. 2. Local injection of adriamycin]

This is the second paper on a trial treatment of malignant brain tumors by postoperative intracavity chemotherapy. In 34 patients with malignant brain tumors in cerebral hemispheres, 0.5 mg adriamycin (ADM) was injected through an Ommaya's device into the tumor-bed every other day after subtotal removal of tumor at craniotomy. Usual total doses of ADM were 5.0-10.0 mg. The patients were usually treated with 60Co-irradiation and immunotherapy after local injection of ADM. Twenty patients with malignant astrocytomas (Kernohan grade 3 or 4) of the cerebral hemisphere were treated with this local injection method of ADM. Clinical effect obtained was 65% and one-year survival rate was 55%. On the other hand, in 14 patients with other malignant brain tumors such as metastatic carcinoma, primary sarcoma, germinoma and medulloblastoma, clinical effect obtained was 36% and one-year survival rate was also 36%. In the autopsy cases of malignant brain tumors, the similar pathological findings were observed as obtained in the patients treated with local injection of bleomycin (BLM). Macroscopically there were extensive necrotic foci, small haemorrhages and increasing fibrin deposit. However, in the cases treated with ADM, the rate of increasing of fibrin debris and necrotic tissues in the tumor cavity were much less than those of in the cases with BLM. Comparative study was carried out on the estimation of the levels of concentration of ADM in the tumor tissues when ADM was injected locally and intravenously. The recurrent tumor tissues were used for the estimation of locally administered ADM.(ABSTRACT TRUNCATED AT 250 WORDS)