S-Space College of Medicine/School of Medicine (의과대학/대학원) Cancer Research Institute (암연구소) Journal Papers (저널논문_암연구소)
Comparison of intrathecal chemotherapy for leptomeningeal carcinomatosis of a solid tumor: Methotrexate alone versus methotrexate in combination with cytosine arabinoside and hydrocortisone
- Kim, Dae-Young; Lee, Keun-Wook; Yun, Tak; Park, Sook Ryun; Jung, Joo Young; Kim, Dong-Wan; Kim, Tae-You; Heo, Dae Seog; Bang, Yung-Jue; Kim, Noe Kyeong
- Issue Date
- Japanese Journal of Clinical Oncology, Vol.33 No.12, pp.608-612
- 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.
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