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Combined intraommaya methotrexate, cytosine arabinoside, hydrocortisone and thio-TEPA for meningeal involvement by malignancies

✍ Scribed by David J. Stewart; Jean A. Maroun; Herman Hugenholtz; Brien Benoit; Andre Girard; Michael Richard; Neville Russell; Lothar Huebsch; Jeanne Drouin


Book ID
104642283
Publisher
Springer US
Year
1987
Tongue
English
Weight
569 KB
Volume
5
Category
Article
ISSN
0167-594X

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✦ Synopsis


Twenty-three adult patients with meningeal involvement by a variety of malignancies were treated with the intra-Ommaya combination of methotrexate, hydrocortisone, cytosine arabinoside, and thio-TEPA. Whole brain irradiation was also administered to most patients who had not previously received it. Most patients demonstrated improvement of cerebrospinal fluid parameters, but only 50% of the patients experienced neurological improvement. Patients who did not receive cranial irradiation and performance status 4 patients were less likely to respond than were patients who did receive cranial irradiation as part of their treatment and patients who were performance status 0-3. Four patients developed possible and 2 patients developed probable or definite serious neurological complications. Another 4 patients developed less severe, reversible neurological toxicity. It is possible (but still uncertain) that this regimen is more toxic than other less intensive regimens, and further studies should be undertaken cautiously.