Intrathecal chemotherapy

Several chemotherapeutic agents have been administered intrathecally, including MTX, thio-TEPA, cytarabine (ara-C), BCNU, hydrochloride (ACNU), and diaziquone (AZQ). These agents have largely produced dissatisfying results, but occasional anecdotal responders or long term survivors have been reported. To date, the four intrathecal agents that have been utilized most often in clinical practice in the United States are MTX, ara-C, sustained release ara-C, and thio-TEPA. There is also increasing...

Cancer Treatment and Research

Rosen, M.D., Series Editor Sugarbaker, P. ed Peritoneal Carcinomatosis Principles of Management. 1995. ISBN 0-7923-3727-1. Dickson, R.B., Lippman, M.E. eds. Mammary Tumor Cell Cycle, Differentiation and Metastasis. 1995. ISBN 0-7923-3905-3. Freireich, EJ, Kantarjian, H. eds y.Molecular Genetics and Therapy of Leukemia. 1995. ISBN 0-7923-3912-6. Cabanillas, F., Rodriguez, M.A. eds Advances in Lymphoma Research. 1996. ISBN 0-7923-3929-0. Miller, A.B. ed. Advances in Cancer Screening....

Sustainedrelease and infusional intrathecal chemotherapy

As mentioned previously, most available intrathecal agents have short pharmacologic half-lives T Vi , which limit their efficacy. Prolonged drug exposure has been forwarded as a method to increase the cytotoxicity of such agents in CSF. It has been shown that some cell lines may be resistant in short exposure conditions, but demonstrate sensitivity with prolonged exposure. For example, in the human SO-M19 melanoma line, there was no inhibition of tritiated thymidine incorporation with short 2...

Hydrocephalus

Ommaya Reservoir

At Memorial Sloan-Kettering Cancer Center MSKCC , approximately 10 of patients referred for placement of Ommaya reservoirs have or develop hydrocephalus.6 This is typically communicating hydrocephalus, resulting from occlusion of the arachnoid granulations necessary for CSF resorption into the venous system or from basilar carcinomatous meningitis. On rare occasions patients will develop a non-communicating hydrocephalus secondary to an obstructing lesion at the foramen of Monro, Sylvian...

Craniospinal Radiation

Craniospinal Irradiation Immobilization

This technique treats the entire craniospinal axis and frequently is utilized with a high rate of success in other malignant diseases of the craniospinal axis, such as medulloblastoma and central nervous system CNS germinoma. Because of the compartmental nature of leptomeningeal carcinomatosis, craniospinal irradiation is occasionally used in the treatment of this disease process. It involves a technically complex set-up of two opposed lateral brain fields and one or two posterior spine fields...

Leptomeningeal Carcinomatosis

Zur Entwicklung des Epitheliomas Cholesteatomas dur Pia under der Lungs. Virchow's Arch 1870 49 51-63. 2. Posner, JB. Leptomeningeal Metastases. In Neurological complication of cancer, Posner JB, Philadelphia, PA F.A. Davis Co., 1995. 3. Grossman SA, Krabak MJ. Leptomeningeal carcinomatosis. Cancer Treat Rev 1999 25 103-1979. 4. DeAngelis LM. Current diagnosis and treatment of leptomeningeal metastasis. J Neurooncol 1998 38 245-52. 5. Freilich RJ, Seidman AD, DeAngelis LM. Central...