Artikel
Carmustine-associated perioperative complications in recurrent glioblastoma
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Veröffentlicht: | 16. September 2010 |
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Gliederung
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Objective: Carmustine wafers are commonly used for local delivery of chemotherapeutics to glioblastoma. Various complications of carmustine wafers have been reported. The aim of this study is to identify carmustine-associated complications in recurrent glioblastoma
Methods: In a prospective study, 11 patients were operated on for recurrent glioblastoma and carmustine wafers were implanted. The postoperative course of events was compared to 11 non-selected consecutive patients undergoing surgery for recurrent glioblastoma without carmustine wafers. Perioperative morbidity and complications with infection, CSF leak, delayed wound healing, seizures, symptomatic severe edema, meningitis, pulmonary embolism and deep-vein thrombosis within 3 months of surgery was recorded for these patients.
Results: Patients in the carmustine group had an overall complication rate of 5 out of 11 (45%) versus 1 out of 11 (9%) in the non-carmustine group. Delayed wound healing in 3 patients (27% ) and wound infection in 2 of 11 patients (18%), cerebrospinal fluid leak in 3 of 11 (27%), deep-vein thrombosis and pulmonary embolism in 1 patient were observed in the carmustine group. In the non-carmustine group seizures and symptomatic severe edema was observed in 1 patient. Because of these complications, an additional second hospitalisation with a mean duration of 16,6 days was necessary in 5 cases of the carmustine group.
Conclusions: The use of carmustine wafers is associated with increased perioperative morbidity. This risk is justified when outweighed by the desired benefit of a prolonged survival with acceptable quality of life. This benefit remains to be verified with adequate numbers of patients.