Treatment of glioblastoma multiforme with high doses of carmustine intracavitary, in an infant

Abstract

Local therapy with nitrosourea compounds (e.g., carmustine [1,3-bis [2-chloroethyl]-1-nitrosourea] wafers) is currently included in the integral treatment offer for patients with glioblastoma multiforme (GBM) [2, 7, 10, 11]. The laboratory recommends that the maximum number of 3.8% carmustine wafers that can be implanted per patient is eight. However, in clinical practice, exceptional cases, such as the one presented here, may arise. In this case, the tumour occupied practically the entire hemisphere, and a higher number of wafers was required to fill the bed completely. The literature includes cases such as that described by Olivi et al. [6], in which doses of up to 20% carmustine per wafer, i.e., five times the recommended dose, can be used with relative safety. However, the ideal dose for children has not yet been defined.