Comparison of intrathecal chemotherapy for leptomeningeal carcinomatosis of a solid tumor: methotrexate alone versus methotrexate in combination with cytosine arabinoside and hydrocortisone.

Abstract

OBJECTIVE:

To compare the efficacy of intrathecal methotrexate single therapy with three-drug combination therapy in patients with leptomeningeal carcinomatosis.

METHODS:

Fifty-five patients who had pathologically proven leptomeningeal carcinomatosis of a solid tumor were evaluated in terms of pathological response. Group M (n = 29) received methotrexate 15 mg and group MHA (n = 26) received methotrexate 15 mg, hydrocortisone 15 mg/m(2) and ara-C 30 mg/m(2) twice a week intrathecally until a cytological response was obtained.

RESULTS:

Primary sites of the tumor were the lung (n = 33), breast (n = 13) and stomach (n = 5). The pathology of 45 patients was adenocarcinoma. The cytological response rate to intrathecal chemotherapy was significantly higher in the MHA group than in the M group (38.5 vs 13.8%, P = 0.036). The median survival was 18.6 weeks in the MHA arm and 10.4 weeks in the M arm (P = 0.029).

CONCLUSION:

Combination intrathecal chemotherapy with methotrexate, cytosine arabinoside and hydrocortisone showed more favorable effects than methotrexate single therapy for leptomeningeal carcinomatosis in solid tumors.

• Authors: Dae-Young Kim, Keun-Wook Lee, Tak Yun, Sook Ryun Park, Joo Young Jung, Dong-Wan Kim, Tae-You Kim, Dae Seog Heo, Yung-Jue Bang, Noe Kyeong Kim
• Journal: Japanese journal of clinical oncology (Jpn J Clin Oncol) Vol. 33 Issue 12 Pg. 608-12 (Dec 2003) ISSN: 0368-2811 [Print] England
• PMID: 14769837 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Cytarabine
• Hydrocortisone
• Methotrexate

Topics

• Adenocarcinoma (drug therapy, mortality, pathology)
• Adolescent
• Adult
• Aged
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Carcinoma, Small Cell (drug therapy, mortality, pathology)
• Cytarabine (administration & dosage)
• Drug Administration Schedule
• Female
• Humans
• Hydrocortisone (administration & dosage)
• Injections, Spinal
• Male
• Meningeal Neoplasms (drug therapy, mortality, pathology)
• Methotrexate (administration & dosage)
• Middle Aged
• Retrospective Studies
• Survival Rate