الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Background: High grade glioma is the commonest primary malignant brain tumor in adults with an incidence of approximately 5 per 100,000.Recurrence after protocol of standard treatment for patients with glioblastoma multiformis is inevitable. This recurrence was attempted to be treated in a non-traditional manner that would involve intra-arterial delivery of carboplatin or its direct local application after a repeat resection. Patients and Methods: This is a prospective study designed for patients have recurrent glioblastoma multiformis between Novemeber 2015 and Novemeber 2019.It was carried out at Mansoura university hospitals, Department of neurosurgery. This study aims to evaluate the efficacy of single dose selective intra-arterial cerebral infusion and tumor bed application of carboplatin for such patients.30 patients (age range 37-76) were diagnosed with recurrent histopathologically proven glioblastoma multiformis GBM after a one surgery at least and followed by standard radiotherapy and temodal. They were all referred from the outpatient neurosurgery clinic. The pateints were grouped into two groups , group A included 21 patients that received intra-aretrial carboplatin and group B included 9 patients that had local application of carboplatin after a repeat resection. Patients were then monitored for response and the associated complications. Results: group A: Two patients showed a significant response and another two showed a partial response 10 showed a stabld disease and 9 had a progressive disease group B: all 9 cases had a progressive disease. Complications: vomiting was reported in 7 cases , epilepsy was present in 8 cases, hemiparesis was diagnosed in 2 cases. Conclusion: Although rGBM has a poor survival, IADD of carboplatin may have a slight positive impact on patient survival where as its local application in the tumor bed after resection did not seem to affect survival. Both IADD and local application are however relatively safe with manageable complications.