Experience with Intrathecal Administration of Methotrexate for Brain Tumor

Abstract

and also as a radiosensitizer, have been applied to some patients with simultaneous radiation therapy.Decompressive craniotomies were usually performed before the treatment, and no serious complication has took place by this application except one case, which treated with intracarotid infusion of 5-FU and was shown to have the carotid occlusion on infused side after the treatment.Clinical and/or radiological improvements were recognized in about half of the cases.By local administrations, about 5 ml. of EX, 20 mg./ml., and/or of MMC, 20 mcg./ml., were spread on tumor-removed areas, and by the cases, continuous intrathecal administrations of methotrexate, 5 mg./day, for 10 days were applied. The intrathecal chemotherapy should be resonable to apply to patients suffering from tumors, which have tendencies of seeding metastatically through CSF or of diffuse spreading along the wall of CSF cavity-meningeal leukemia, meningeal carcinosis, intraventricular tumor or medulloblastoma etc.-, for CSF concentration of the drug is maintained to be remarkably high. We have administered Methotrexate intrathecally to two patients with brain tumor. CSF cytology by sedimentation chamber method was used for evaluation of the effectiveness of the chemotherapy together with interpretation of the clinical course. Case 1. A 34 year old male had subtotal resection and decompression surgery for glioblastoma multiforme in the right temporal lobe. Two months later, Methotrexate 70 mg. was injected intrathecally from the -134-