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CASE REPORT
Year : 2018  |  Volume : 13  |  Issue : 4  |  Page : 1171-1174

Adverse event with the use of carmustine wafers and postoperative radiochemotherapy for the treatment of high-grade glioma


1 Department of Neurosurgery, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Henri-Mondor Albert-Chenevier, PePsy Department; U955 INSERM IMRB eq. 14 Université Paris 12 UPEC, Faculté de Médecine, F-94010 Créteil, France; Department of Neurosurgery, Hospital Maciel-ASSE, Montevideo, Uruguay
2 Department of Neurosurgery, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Henri-Mondor Albert-Chenevier, PePsy Department, F-94010 Créteil, France
3 Department of Neurosurgery, Hospital Maciel-ASSE, Montevideo, Uruguay
4 Department of Neurosurgery, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Henri-Mondor Albert-Chenevier, PePsy Department; U955 INSERM IMRB eq. 14 Université Paris 12 UPEC, Faculté de Médecine, F-94010 Créteil, France

Correspondence Address:
Dr. Federico Salle
Pedro Bustamante 1453, CP 11600, Montevideo, Uruguay

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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ajns.AJNS_235_16

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Randomized, controlled trials have shown significant improvement of survival after implantation of 1,3-bis(2-Chloroethyl)-1-nitrosourea (BCNU) wafers for patients suffering from high-grade glioma. A combination of local chemotherapy with BCNU and concomitant radiochemotherapy with temozolomide (TMZ) appears to be attractive to enhance the overall survival, even though these treatments may potentially cumulate their toxicity.We report a clinical case of a patient submitted to this combined treatment protocol. Severe brain edema and a cystic formation in the surgical cavity rapidly developed. Data supporting the use of Gliadel® combined with TMZ comes from small retrospective studies, and some series have shown a very high rate of adverse events (AEs) when this multimodality treatment is applied. Combined protocols of local and systemic chemotherapy might provide survival benefits, although AEs seem currently underestimated.


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