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55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

25. bis 28.04.2004, Köln

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Capillary permeability, blood volume and regional blood flow in primary CNS lymphomas – Impact on drug delivery

Kapilläre Permeabilität, Blutvolumen und regionale Durchblutung in primären ZNS-Lymphomen - Einfluss auf die Chemotherapie

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  • K. Kopitzki - Department of Neurosurgery, The University of Liverpool, Liverpool /UK; Abt. Stereotaktische Neurochirurgie, Universitätsklinikum Freiburg, Freiburg
  • F. J. Hans - Department of Neurosurgery, The University of Liverpool, Liverpool /UK; Abt. Stereotaktische Neurochirurgie, Universitätsklinikum Freiburg, Freiburg
  • J. Timmer - Department of Neurosurgery, The University of Liverpool, Liverpool /UK; Abt. Stereotaktische Neurochirurgie, Universitätsklinikum Freiburg, Freiburg
  • C. B. Ostertag - Department of Neurosurgery, The University of Liverpool, Liverpool /UK; Abt. Stereotaktische Neurochirurgie, Universitätsklinikum Freiburg, Freiburg
  • corresponding author Peter-Christian Warnke - Department of Neurosurgery, The University of Liverpool, Liverpool /UK; Abt. Stereotaktische Neurochirurgie, Universitätsklinikum Freiburg, Freiburg

Deutsche Gesellschaft für Neurochirurgie. Ungarische Gesellschaft für Neurochirurgie. 55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie. Köln, 25.-28.04.2004. Düsseldorf, Köln: German Medical Science; 2004. DocDI.07.08

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2004/04dgnc0219.shtml

Published: April 23, 2004

© 2004 Kopitzki 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

Primary CNS lymphomas represent a unique intracerebral tumour entity being chemosensitive to water-soluble drugs in almost up to 70% of cases. These clinical findings indicate different vascular physiology of lymphomas resulting in favourable drug delivery parameters.

Methods

Blood-brain transport (K1), brain-blood transport (K2) plasma vascular space and the size of the extracellular space were measured using dynamic spiral-CT and tumoural blood flow was assessed using stable-Xenon CT in 7 patients. All patients were off steroids and untreated. Histology was verified from stereotactic biopsies.

Results

Capillary permeability (K1) ranged from 16.1 ± 14.2 to 43.5 ± 30.3 μl /gm/min with a mean of 29.47 ± 10.6. Vascular space ranged from .002 ± .007 to .065 ± .075 ml/gm with a mean of .027 ± .024. The efflux constant (K2) showed a mean of 58.3 ± 44 min and the extracellular space showed a mean of .33 ± .27 ml/gm with a range of .19 to .42 ml/gm. Tumoural blood flow showed a mean of 43.16 ± 12.4 ml/100g/min as compared to normal brain with a 52.3 ± 13.4 ml/100g/min. pillary permeability was significantly increased in lymphomas (p<.001 for GBM, p<.005 for medulloblastomas and p<.01 for metastases) and blood flow was not significantly different from that of normal brain (p>.05, t-test).

Conclusions

Primary CNS lymphomas form a unique tumour entity within the brain with a high capillary permeability for water-soluble compounds and a small extracellular space, thus reducing the sink effect for chemotherapy. Also blood flow is higher than in all other measured brain tumours.