Eaph-11. Intraventricular Therapy Alternating Etoposide, Aqueous Cytarabine and Topotecan Is Feasible and Safe: Experience in 26 Pediatric Patients With Malignant Brain Tumors

Triple intraventricular chemotherapy for treatment of relapsed choroid plexus carcinoma

“…7,23 Intraventricular etoposide doses range from 0.25 to 1 mg, every 12 or 24 hours for 5-10 days every 2-5 weeks. 12,22,23 A simplified regimen of 1 mg weekly has also been documented in an adult case report. 24 Intraventricular etoposide was reportedly well tolerated, 23 and Slavc et al observed no immediate toxicities.…”

“…19 Topotecan has poor CNS penetration (less than 5%, although the active form achieves moderate penetration -less than 30%). 18,21 Most paediatric studies describe intra-CSF doses of 0.4 mg every 1-2 weeks, 16,22 although other case reports have also used 0.2-0.4 mg every 2-4 weeks. 13 Fever or chemical arachnoiditis has been noted with intraventricular topotecan.…”

Approaches to Minimise the Neurodevelopmental Impact of Choroid Plexus Carcinoma and Its Treatment

“…Metastatic disease in CPC patients is a poor prognostic factor [ 96 ]. In young patients with metastatic disease, intrathecal chemotherapy (IT) has been used as CNS-directed therapy, and there are accumulating data to suggest this to be an effective administration route in brain tumour patients [ 97 , 98 ]. However, there is no current evidence to show an additional benefit of IT in up-front treatment or in the recurrent setting, although some reported efficacy has been shown in the relapsed CPC [ 21 , 99 ].…”