Autor: Lode J. Swinnen, Allen Cohn, Mark R. Gilbert, Julia M. Kennedy, Warren Mason, Robert Aiken, Surasak Phuphanich, Deborah Heros, Eric T. Wong, Kurt A. Jaeckle, Dorcas Fulton, Stephen B. Howell, Christy A. Russell, Paul L. Moots, Pamela New, Steven J. O'Day, John Gutheil, Lisa R. Rogers, Said Baidas, Tracy T. Batchelor, Glenn J. Lesser
Rok vydání: 2002
Předmět:
Zdroj: Journal of Neuro-Oncology. 57:231-239
ISSN: 0167-594X
DOI: 10.1023/a:1015752331041
Popis: Drugs currently available for intrathecal administration are cleared rapidly from the CSF. DepoCyt is a slow-release formulation of cytarabine that maintains cytotoxic concentrations of free cytarabine in the CSF for >14 days following a single injection. DepoCyt was administered to 110 patients with a diagnosis of neoplastic meningitis based on either a positive CSF cytology (76) or neurologic and CT or MRI scan findings sufficient to document neoplastic meningitis (34). Patients were treated with DepoCyt 50mg every 2 weeks for 1 month of induction therapy by either lumbar puncture (LP) or intraventricular (IVT) injection. Patients without neurologic progression were candidates to receive an additional 3 months of consolidation therapy. All patients received dexamethasone 4 mg BID on days 1-5 of each cycle. Median time to neurologic progression was 55 days; median overall survival was 95 days. Among the 76 patients with a positive CSF cytology at baseline, 70 were evaluable for response, and of this group 19 (27%) attained the criteria for response (cytologic response in the absence of neurologic progression). The most important adverse events were headache and arachnoiditis. When drug-related, these were largely low grade, transient, and reversible. Drug-related grade 3 headache occurred on 4% of cycles; grade 3 or 4 arachnoiditis occurred on 6% of cycles. No cumulative toxicity was observed. DepoCyt injected once every 2 weeks produced a response-rate comparable to that previously reported for methotrexate given twice a week. The once in every 2-week-dosing interval offers an advantage over conventional schedules (2-3 doses/week) used for other agents available for intrathecal injection.
Databáze: OpenAIRE
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