The Entire Development Behind Vandetanib
Indeed, in patients with newly diagnosed GB who underwent surgical resection and received carmustine wafer implants followed by adjuvant radiotherapy and concomitant oral TMZ chemotherapy, MGMT promoter methylation status and low MGMT expression were identified Itraconazole as positive prognostic factors (10). In the present case, the tumor was highly responsive to carmustine wafers, and also exhibited genetic characteristics conferring sensitivity to alkylating agents. Previous pharmacokinetic studies on animals and associated modelling demonstrated the ability of carmustine wafers to produce high-dose delivery (millimolar concentrations) within millimeters of the polymer implant, with a limited selleck chemicals penetration distance of carmustine from the site of delivery (13). In addition, the presence of significant doses of carmustine in more distant regions of the brain (centimeters away from the carmustine wafer implant) has been shown to persist over the course of 1 week in non-human primates (13). However, Fung et al (12) revealed that a significant concentration of carmustine (0.4 ?M) was detected at up to 5 cm from the implant as late as 30 days after implantation, although a high drug concentration (0.5�C3.5 mM) was measured within 3 mm. Therefore, it may be preferable for carmustine wafers to be placed as close to the residual tumor as possible. We consider that effective placement of wafers was accomplished in the present case. For GB patients subjected to ��90% resection in the BCNU wafer study, the median survival increased compared with that of placebo-treated controls, while no further survival increase was found for cases with selleck inhibitor effect and if the resulting resection cavity is of sufficient size for wafer implantation. As demonstrated in the present case, although the tumor was only partially resected, it was considered that carmustine wafers could be implanted if the mass effect was significantly reduced and the resection cavity was of sufficient size. However, one should always consider the possibility of brain edema, resulting in severe, albeit transient, neurological deficits (15).
