Journal of Clinical Oncology, Vol 4, 68-73, Copyright © 1986 by American Society of Clinical Oncology

ARTICLES

Combination intraventricular chemotherapy for meningeal neoplasia

L Giannone, FA Greco and JD Hainsworth

Twenty two patients with meningeal neoplasia were treated with biweekly combination intraventricular chemotherapy using methotrexate, cytosine arabinoside, and thiotepa. Patients with the following malignancies were included: breast cancer, ten patients; lung cancer, seven; non- Hodgkin's lymphoma, two; malignant melanoma, one; transitional cell carcinoma of the bladder, one; and malignant glioma, one. Eight of 22 patients (36%) had a Karnofsky performance status of less than 50%. Eleven of 22 patients received radiotherapy to symptomatic areas, and seven received systemic chemotherapy in addition to combination intraventricular therapy. Patients were evaluated for both toxicity and response to therapy. Myelosuppression was the major toxic condition and occurred in 17 of 22 patients (77%). Ten patients (45%) had a nadir WBC count of less than 1000/microL or a platelet count of less than 25,000/microL. No patient achieved a complete response (CR), although nine patients (41%) had partial responses (PRs) lasting 4 to 24 + weeks. Median survival for the entire group was 10 weeks (range, 6 to 24+ weeks). In this small group of patients, simultaneous triple-drug intraventricular chemotherapy caused unacceptable myelosuppression without increasing the response rate, response duration, or survival when compared with single-agent methotrexate and radiotherapy.
CiteULike    Complore    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				M. L de Lemos, S. Monfared, T. Denyssevych, L. Hamata, S. Jennings, B. Thiessen, S. Smith, and D. Waterhouse Evaluation of osmolality and pH of various concentrations of methotrexate, cytarabine, and thiotepa prepared in normal saline, sterile water for injection, and lactated Ringer's solution for intrathecal administration Journal of Oncology Pharmacy Practice, March 1, 2009; 15(1): 45 - 52. [Abstract] [PDF]

				M. C. Chamberlain Neoplastic Meningitis Oncologist, September 1, 2008; 13(9): 967 - 977. [Abstract] [Full Text] [PDF]

				H. Nakagawa, K. Yoshioka, E. Miyahara, Y. Fukushima, M. Tamura, and K. Itoh Intrathecal Administration of Y-27632, a Specific Rho-Associated Kinase Inhibitor, for Rat Neoplastic Meningitis Mol. Cancer Res., August 1, 2005; 3(8): 425 - 433. [Abstract] [Full Text] [PDF]

				M. C. Chamberlain Neoplastic Meningitis J. Clin. Oncol., May 20, 2005; 23(15): 3605 - 3613. [Abstract] [Full Text] [PDF]

				M. C. Chamberlain Commentary Regarding Neoplastic Meningitis Secondary to Multiple Myeloma Arch Neurol, May 1, 2005; 62(5): 833 - 833. [Full Text] [PDF]

				D.-Y. Kim, K.-W. Lee, T. Yun, S. R. Park, J. Y. Jung, D.-W. Kim, T.-Y. Kim, D. S. Heo, Y.-J. Bang, and N. K. Kim Comparison of Intrathecal Chemotherapy for Leptomeningeal Carcinomatosis of a Solid Tumor: Methotrexate Alone Versus Methotrexate in Combination with Cytosine Arabinoside and Hydrocortisone Jpn. J. Clin. Oncol., December 1, 2003; 33(12): 608 - 612. [Abstract] [Full Text] [PDF]

				I. Barista and S. B. Howell Intrathecal Cytarabine and Bone Marrow Suppression J. Clin. Oncol., May 9, 2000; 18(9): 2003 - 2004. [Full Text] [PDF]

				M. J. Glantz, K. A. Jaeckle, M. C. Chamberlain, S. Phuphanich, L. Recht, L. J. Swinnen, B. Maria, S. LaFollette, G. B. Schumann, B. F. Cole, et al. A Randomized Controlled Trial Comparing Intrathecal Sustained-release Cytarabine (DepoCyt) to Intrathecal Methotrexate in Patients with Neoplastic Meningitis from Solid Tumors Clin. Cancer Res., November 1, 1999; 5(11): 3394 - 3402. [Abstract] [Full Text] [PDF]

				M. C. Chamberlain Topical Review: A Review of Leptomeningeal Metastases in Pediatrics J Child Neurol, May 1, 1995; 10(3): 191 - 199. [Abstract] [PDF]

				R. Grant, B. Naylor, H. S. Greenberg, and L. Junck Clinical Outcome in Aggressively Treated Meningeal Carcinomatosis Arch Neurol, May 1, 1994; 51(5): 457 - 461. [Abstract] [PDF]

				T. Graves and J. Pruemer New Methods of Chemotherapy Administration-Selected Routes Journal of Pharmacy Practice, January 1, 1991; 4(1): 49 - 63. [PDF]