Brain tumor chemotherapy with intrathecal methotrexate

Abstract

Two patients harboring recurrent posterior fossa tumors were treated with intrathecal methotrexate. The patient with an ependymoma responded dramatically and, when he died of a leukoencephalopathy 2 years later, no evidence of intracranial tumor remained. A medulloblastoma in the second patient responded to methotrexate but became moderately drug resistant and spread to bone. In this case, concomitant use of intrathecal methotrexate and systemic citrovorum factor offered no apparent advantage. Relevant literature relating to methotrexate and tumor kinetics is reviewed. In the light of present knowledge, brain tumors selected for intrathecal methotrexate should be treated weekly for an indefinite period of time. The need for additional information regarding the behavior of citrovorum factor in the central nervous system is acknowledged. Copyright © 1969 American Cancer Society