gms | German Medical Science

63rd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Japanese Neurosurgical Society (JNS)

German Society of Neurosurgery (DGNC)

13 - 16 June 2012, Leipzig

Evaluation of complications of Carmustin Wafer implantation in recurrent GBM

Meeting Abstract

  • G. Satilmis - Neurochirurgische Klinik, Henrich-Heine-Universität, Düsseldorf
  • S.M.A. Zella - Neurochirurgische Klinik, Henrich-Heine-Universität, Düsseldorf
  • M. Wallocha - Neurochirurgische Klinik, Henrich-Heine-Universität, Düsseldorf
  • J. Schroeteler - Neurochirurgische Klinik, Westfälische Wilhelms-Universität, Münster
  • H.J. Steiger - Neurochirurgische Klinik, Henrich-Heine-Universität, Düsseldorf
  • M.C. Sabel - Neurochirurgische Klinik, Henrich-Heine-Universität, Düsseldorf

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS). Leipzig, 13.-16.06.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocSA.07.05

DOI: 10.3205/12dgnc345, URN: urn:nbn:de:0183-12dgnc3451

Published: June 4, 2012

© 2012 Satilmis et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

Text

Objective: Carmustine (1,3-bis [2-chloroethyl]-1-nitrosourea, or BCNU, Gliadel©) wafers are approved for treatment of recurrent glioblastoma and newly diagnosed malignant glioma (MG). Since the approval studies were performed prior to the introduction of combined radiochemotherapy (Stupp protocol), the safety of BCNU wafers needs a re-evaluation. We therefore conducted a retrospective evaluation study of complications occurring after the implantation of Gliadel Wafers in patients with recurrent GBM pretreated according to the Stupp protocol.

Methods: Inclusion criteria for this retrospective case control study were recurrent GBM, pretreated according to the Stupp protocol and implantation of Gliadel wafer at our institution. Complications were identified from hospital records and our Glioma-Database.

Results: We identified 71 patients who met the inclusion criteria. Patients were treated with Gliadel wafer implantation between 2008–2010 for first to third recurrence. 12 patients [8.5%] showed a surgical site infection. 4 patients [2.8%] developed an intracranial abscess; 1 patient [0.7%] a bacterial meningitis. 9 patients [6.4%] suffered from a postoperative CSF leak, 8 patients [5.7%] received a VP-shunt due to a post-operative hydrocephalus. 5 patients [3.6%] developed a marked cerebral edema. Neurological deficits potentially attributed to Gliadel-Wafer implantation were observed in 11 patients [7.8%].1 patient experienced a transient acute psychosis, 3 patients developed a prolonged alteration of mental status and 1 patient [0.7%] suffered from post-operative seizures.

Conclusions: In comparison to published data on complications of craniotomies, Carmustine wafer implantation in this high risk population results in an acceptable rate of complications.