Gliadel为一种白色至灰白色的一角硬币大小的薄膜,包含生物可降解聚合物聚苯丙生20和7.7mg卡莫司汀(carmustine,BCNU),卡莫司汀是治疗恶性胶质瘤的常用静脉给药的化疗药物。 关键字:卡莫司汀植入膜剂(Gliadel)
Polifeprosan 20 with Carmustine Implant Gliadel Wafer格立得植入剂 --------------------------------------------------------------- 该药品相关信息网址1: 卡莫司汀植入膜剂(格立得植入剂Gliadel)—是全球唯一治疗恶性胶质瘤的希望药物 GLIADEL WAFER格立得植入剂(卡莫司汀植入膜剂) How to Use GLIADEL® Wafer
1. Preparation for Use Maximize resection of tumor Send tumor specimen to pathologist to confirm malignant glioma Achieve hemostasis before implantation to eliminate bleeding Obtain clear irrigation fluid 2. Handle Wafers carefully due to fragility and toxicity of carmustine Use double surgical gloves 3. Opening the GLIADEL pouch (outer surface of foil pouch is not sterile) Open outer pouch: peel folded corner in outward motion Do not pull downward this may break wafer Remove inner pouch: with forceps, grab crimped edge, pull upwards Open inner pouch: gently hold crimped edge, cut around wafer Remove wafer: gently grasp with forceps, place onto sterile field 4. Implanting GLIADEL 5. Securing the Wafers Take extra care to decrease risk of CSF leaks and infection Suction to ensure no blood in cavity Irrigate resection cavity before closure If necessary, use a graft of autologous, nonsynthetic or synthetic dura patch or substitute Treat CSF leaks aggressively Manage edema withaggressiveandprolongedcorticosteroidtreatmentBeginanticonvulsants before surgery (recommended for all patients) The information described above is a general example intended to help educate individuals on GLIADEL® Wafer. The information provided is neither a substitute for professional medical advice nor intended to provide treatment options. The text and graphics depicted do notreplacetheservicesofaphysicianordoctorpatientrelationship. The use of the information is at the discretion of the reader. The reader should always consult a qualified medical expert in the use of GLIADEL® Wafer. Eisai makes no representations or warranties with respect to any information provided on this graphic and is not liable for any direct or indirect claim, loss or damage resulting from the use of this information. Important Safety Information Indications: Contraindication: Warnings: Cases of intracerebral mass effect unresponsive to corticosteroids have been described in patients treated with GLIADEL, including one case leading to brain herniation. Precautions: Computed tomography and magnetic resonance imaging of the head may demonstrate enhancement in the brain tissue surrounding the resection cavity after implantation of GLIADEL. This enhancement may represent edema and inflammation caused by GLIADEL or tumor progression. The short-term and long-term toxicity profiles of GLIADEL when given in conjunction with chemotherapy have not been fully explored. Pregnancy and Nursing: It is recommended that patients receiving GLIADEL discontinue nursing. Adverse Events: Seizures: In the surgery for recurrent disease trial, the incidence of post-operative seizures was 19% in both patients receiving GLIADEL and placebo. In this study, 12/22 (54%) of patients treated with GLIADEL and 2/22 (9%) of placebo patients experienced the first new or worsened seizure within the first five post-operative days. The median time to onset of the first new or worsened post-operative seizure was 3.5 days in patients treated with GLIADEL and 61 days in placebo patients. Brain Edema: Healing Abnormalities: In the surgery for recurrent disease trial, the incidence of healing abnormalities was the 14% of GLIADEL treated patients and 5% in patients receiving placebo wafers. Intracranial Infection: FDA已批准Gilladel Wafer 辅助治疗恶性神经胶质瘤 FDA已批准GilladelWafer用于辅助手术和放疗治疗高度恶性神经胶质瘤。 How GLIADEL® Wafer is Used GLIADEL Wafer is implanted in the brain along the walls and floor of the cavity created after a malignant glioma has been surgically removed. Up to 8 wafers may be placed in the area where the tumor was located. The number of wafers implanted depends on the size of the space left after the removal of the tumor. As they dissolve, the wafers release carmustine into the surrounding cells. GLIADEL Wafer is implanted in the brain along the walls and floor of the cavity created after a malignant glioma has been surgically removed. A surgeon may place up to 8 wafers. The graphic above shows a cavity in which 6 wafers were implanted. Indications
GLIADEL® Wafer (polifeprosan 20 with carmustine implant) is indicated in patients with newly diagnosed GLIADEL Wafer is also indicated in patients with recurrent glioblastoma multiforme as an adjunct to surgery. Important Safety Information You should not be given GLIADEL Wafer if you are allergic to carmustine or any of the components of GLIADEL Wafer. If you are undergoing surgery for malignant glioma and implantation of GLIADEL Wafer, you should be monitored closely for known complications, including convulsions, infections, abnormal wound healing, and swelling of the brain. If you are pregnant or are planning to become pregnant, you should understand that carmustine, the active component of GLIADEL Wafer, can cause harm to the fetus if given to a pregnant woman. It is not known if either carmustine, or other components of GLIADEL Wafer are excreted in human milk. Many drugs are excreted in human milk and there is a risk for serious side effects from carmustine in nursing infants; therefore discontinuation of nursing is recommended if you will be receiving GLIADEL Wafer. It is possible that if GLIADEL Wafers are not implanted properly, they could block the flow of cerebrospinal fluid and might cause abnormal accumulation of fluid in the brain (obstructive hydrocephalus). The short-term and long-term safety of GLIADEL Wafer when given together with chemotherapy is not fully known. Following surgery to remove a brain tumor and implantation of GLIADEL Wafer, the following side effects have been reported in clinical studies: Seizures (convulsions): In clinical studies, seizures have occurred within days or several weeks following implantation of GLIADEL Wafer. Both new seizures and worsening of seizures have been reported. Brain Swelling: Brain swelling has occurred in clinical studies. In some cases, brain swelling may require another surgery, and removal of GLIADEL Wafers or remnants of the wafers may be required. Abnormal wound healing: In clinical studies, abnormal healing of the surgical wound has occurred following implantation of GLIADEL Wafer. These abnormalities included reopening of the surgical area, leaking of brain or spinal fluid, delays in healing, or other abnormalities in how the wound heals. Brain Infections: In clinical studies, brain infections, including meningitis, have occurred following implantation of GLIADEL Wafer. Please read the full Prescribing Information and discuss it with your doctor or healthcare professional. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.FDA.gov/medwatch or call 1-800-FDA-1088. |