Route of intracerebrospinal fluid chemotherapy administration and efficacy of therapy in neoplastic meningitis.

摘要: BACKGROUND: A study was undertaken to determine whether route (intraventricular vs intralumbar) of intracerebrospinal fluid (intra-CSF) drug administration influences progression-free survival in the treatment patients with neoplastic meningitis, which occurs 1% 5% known cancer. Currently available options result modest responses, is part a reflection obstacles delivery into leptomeningeal space. METHODS: One hundred clinically and cytologically or radiographically documented meningitis because solid cancers received intra-CSF liposomal cytarabine methotrexate as specified randomized phase 4 trial. The 2 arms were well balanced for demographic tumor-related characteristics prognostic importance, including age, performance status, tumor type, extent systemic other central nervous system (CNS) disease, prior CNS therapy, concurrent chemotherapy. RESULTS: One treated (52 sustained-release cytarabine, 48 methotrexate). Progression-free (the primary endpoint) identical between all 100 (35 37.5 days, P = .79). When examined function chemotherapy (lumbar ventricular), there no difference (29 43 .35). For methotrexate, however, statistically significant favoring receiving intraventricular therapy (19 .048). CONCLUSIONS: Site relevant short half-life drugs such methotrexate. Cancer 2010. © 2010 American Society.