Clinical Treatment of Brain Tumor with Carotid Artery Injection of Elemene Milk

ZHANG Li, WANG Xu, LIU Yang, The Armed Police Hospital, Jilin

HU Zhixin et al, Nan Guan Qu Zhong Xi Yi Jie He Yi Yuan

 

From March 1996 to September 1998, 38 brain tumor patients were treated with carotid artery injection of elemene milk. The following is a brief introduction.

1. Materials and Methods

① General information: 38 patients, including 16 men and 22 women; aged between 15-62 years, with an average of 44.5. Head CT scans were carried out before and after the treatment, showing the focus of 17 patients was in the temporal lobe, the focus of 11 patients was in the frontal and parietal lobe, 10 patients had multiple metastasis tumors. 11 patients were given a surgery to remove the supratentorial tumors. Pathological analysis found 6 patients had glioblastoma. ② Method: carotid artery injection, carotid artery on the same side with the brain tumors was punctured. Puncture was done on both sides if tumors showed in both sides. When punctured, patients lay flat on the bed with the pillow taken away. Carotid artery was punctured with No. 7 needle. After blood was seen, first inject 10 mg dexamethasone and 20ml 20% mannitol, and then inject 200mg elemene milk and10 ml normal saline. The total amount was 50 ml, given once a day for10 days for a treatment period.

2. Results

① efficacy The patients were followed up for about two years. After a course of treatment, in 11 patients the size of tumors decreased by more than 50 percent, the 15 patients with tumor size reduced by less than 50 per cent were in stable condition. The results of 12 cases were invalid. Six patients died due to multiple metastases, 4 weeks and 23 weeks after treatment. The total efficacy rate was 68%. ② observation and treatment of side effects: during the injection elemene milk, wetness and redness on the face were detected sometimes with a sense of fever, but the symptoms would soon alleviate without intervention; as long as no liquid leakage occurred at the neck puncture site, there would be no local swelling and stimulation; once a liquid leakage was detected, the needle should be pulled out immediately, and puncture site should be pressed for 5 min; later a new site should be chosen to give a puncture.

3. Discussion

Elemene was an anti-active ingredient extracted from the anti-cancer medicine-Ezhu. Its main component was β-elemene, which was proven by animal and clinical experiments with significant tumors-inhibition effect. Massive basic researched revealed that Elemene milk could inhibit DNA, RNA and protein synthesis of a variety of tumor cells; it also worked directly on the cell membrane to induce death of tumor cells. It can change or promote immunization to tumor cells. Elemene can induce tumor cells to shrink, get round, slow down the proliferation and show apoptosis changes. Compared with other than cytotoxic chemotherapy drugs, elemene milk had fewer side effects.

After carotid artery injection of elemene milk, although some drugs entered the eye artery, the vision and fundus vascular were not impacted, which further confirmed that elemene milk had few side effects. It was suspected that the facial skin wetness and redness seen in some patients in this group were caused by drugs that entered the external carotid artery on the same side.
  Before the injection of elemene milk, injecting 20% mannitol helped to pass the blood-brain barrier; because elemene could pass through the brain barrier, its concentration in the brain increased so that the focal drug concentration was higher, the effects of chemotherapy was better. The use of dexamethasone with Mannitol can not only reduce allergic reactions and the incidence of side effects, but also can play the role of dehydration so as to reduce the cerebral edema.