[Treatment of peritumoral cerebral edema with tetracosactide]

Tetracosactide is known to be used in brain tumours, but its action is difficult to evaluate clearly. Tetracosactide exerts analgesic, anti-emetic and anti-inflammatory effects and it reduces the oedema surrounding brain tumours. It is this latter effect which we have studied. We used a technetium-labelled cerebral marker, 99mTc HMPAO (Ceretec), and found that this functional exploration not only detects the presence of a brain tumour, but also measures regional cerebral blood flow. This marker is mainly used in intracerebral vascular diseases. Since february 1990, eighteen patients suffering from malignant brain tumour with pronounced perilesional oedema were selected and treated with tetracosactide for two days. With the help of 99mTc HMPAO scintigraphy the oedema was quantified, and the results obtained were interpreted. The initial results of this clinical experiment indicate that the phenomena observed were due to improved vascularization of the healthy peritumoral areas with resorption of oedema. This was a consequence of the direct tetracosactide action, and the higher the dose of this compound, the clearer its action.