[Reversible opening of the blood-brain barrier in the chemotherapy of malignant gliomas].

The concept of a blood brain or blood tumour barrier blocking the passage of lipid insoluble cytoreductive drugs from blood into brain-tumor, leads to a protocol of intraarterial injection of high dose methotrexate (MTX) during reversible, osmotic blood brain barrier disruption (BBBD). Malignant Gliomas of grades III and IV in 9 patients and one primary CNS-lymphoma in one patient have been treated in 2 to 5 sessions per patient with BBBD plus polychemotherapy (MTX, cyclophosphamide, procarbazine). Median progression free intervals (PFI) which are still in continuation are 12.2 months. Median PFI which had been terminated by tumour recurrence are 7.75 months.