Intraventricular methotrexate as part of primary therapy for children with infant and/or metastatic medulloblastoma: Feasibility, acute toxicity and evidence for efficacy

European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)
Raisa S PompeStefan Rutkowski

Abstract

To assess feasibility, acute toxicity, and efficacy of intraventricular methotrexate administered as part of the primary therapy in medulloblastoma. From 2001 to 2007, 240 patients < 22 years from 61 treatment centres were registered. Patients received 2-3 cycles of intraventricular methotrexate with systemic chemotherapy in three different treatment arms of the prospective multicentre trial HIT2000 (150 children > 4 years with metastatic, 59 < 4 years with non-metastatic, 31 < 4 years with metastatic medulloblastoma). 211 patients received an intraventricular access device with a subcutaneous reservoir for the application of chemotherapy. Reservoir-associated complications were documented in 57 (27%) patients, mostly due to infection (n = 32) and reservoir malfunction (n = 19), requiring removal in 39 (18%) patients. Acute neurotoxicity likely associated with intraventricular MTX was observed in 9/202 documented patients. Toxicity was usually mild, apart from one therapy-associated death due to toxic oedema followed by seizures. Of 519 treatment cycles including intraventricular methotrexate, 226 (43%) were reduced or omitted, most frequently due to the absence of an intraventricular device. Survival rates were higher in patie...Continue Reading

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Citations

Jan 3, 2016·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·Emeritus Ian J Cohen
Dec 3, 2016·Pediatric Blood & Cancer·Janina H WalkerNicolas U Gerber
Nov 21, 2017·Neuro-oncology·Mohamed S AbdelBakiMark W Kieran
Sep 13, 2019·Pediatric Blood & Cancer·Amardeep S GrewalChristine Hill-Kayser
Apr 25, 2020·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Martin MynarekStefan Rutkowski
Sep 21, 2018·Wiener medizinische Wochenschrift·Wolfgang GrisoldAnna Grisold
Sep 14, 2017·Journal of Materials Chemistry. B, Materials for Biology and Medicine·Hongxia WangFuyuan Ding
Nov 20, 2016·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·André O von BuerenStefan Rutkowski
Sep 27, 2018·International Journal of Molecular Sciences·Martina Da RosIacopo Sardi
Apr 6, 2021·Pediatric Blood & Cancer·Colette J ShenKaren J Marcus
Jan 21, 2020·The Lancet Child & Adolescent Health·David A WalkerChristina Halsey

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