SCDT-21. CEREBRAL INTRAARTERIAL CHEMOTHERAPY IN THE TREATMENT OF MALIGNANT GLIOMAS: READY TO RISE AGAIN
Bibliographic record
Abstract
Contemporary treatment of glioblastoma involves an optimal surgery, followed by a combination of radiation and temozolomide. The reported progression-free survival with this treatment is only 6.9 months. At recurrence, few therapeutic options are available given the paucity of chemotherapeutics crossing the blood-brain barrier (BBB). Cerebral Intra-arterial Chemotherapy (CIAC) in the treatment of gliomas allows to bypass the BBB and the brain-tumor barrier (BTB), but fell into oblivion after a major randomized study led by the BTCG showed no therapeutic advantages, and a major complication profile. Looking at the reasons for this failure, the choice of chemotherapeutics, concentration, volume and infusion rate, catheter placement can all be invoked. But nowadays, with refinements in angiographic hardware and technics, and the availability of new therapeutics, CIAC is ready to rise again. In this work, we present the largest series of glial tumors treated by CIAC to our knowledge. Over 15 years, 463 glial tumors comprising 319 GBM tumors were treated at the CHUS (centre Hospitalier Universitaire de Sherbrooke) with a standardized CIAC protocol of monthly carboplatin administration. All patients were treated at relapse. Seventeen percent were treated at first relapse, 68% at second relapse, 11% at third relapse and 4% at fourth. Overall, the patient received a median of 4 cycles (1 to 22 cycles). The whole series presented an overall median survival of 25 months, whereas survival from study entry was 8 months for the entire cohort. Ten patients are still alive, with the longest survival now at 12 years. The overall complication rate was 0.75%, with the most frequent occurrence being lacunar strokes. We believe that a better selection of patient, molecular subclassification, and the continued search for chemotherapeutics will improve these results. The procedure is safe, and should be considered an easy and viable delivery option to circumvent BBB.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".