Abstract Details

Title Intrathecal Chemotherapy (Part II): Changes in Procedures and Technique. Evaluation of Results

Topic Neuro-oncology

Presentation(s) P01 - (-)

Poster/Presentation
Number 100

Objective

Background Between 2002-2005 we performed 100 IT-ChT with 37/100 adverse events with the aim of delineating a procedure/technique protocol for IT ChT with improved results.

Design/Methods Between 2008-2012 we performed the second 100 IT-ChT procedures. Only staff appropriately trained prepared the dose and filled the syringe with cytotoxic drug reconstitution only with 0.9% Sodium Chloride. Only well-known brands of drugs were used. No anesthesia was performed. The technique was standardized as follows: a) all lumbar puncture (LP) were performed with the patient in the right lateral decubitus; b) one trademark LP 21-gauge needle, with bevel up or down, preferably at L3-L4 space; c) CSF leakage equivalent to the volume of drug to be administered; d) application of drugs in separate syringes at a rate of 0.5 ml/15 seconds and, after every 1 ml was introduced, 0.25 ml was aspirated as a verification of the needle's position; e) following the chemotherapy scheme: first syringe with dexamethasone (4-8 mg); second syringe with MTX (12-15 mg); third syringe with Ara-C (30-33 mg); f) withdrawal of the needle with syringe in position; g) evaluation of immediate complications.

Results 100 IT-ChT were performed in 30 patients diagnosed with: non-Hodgkin lymphoma (78/26 administrations/patients), leptomeningeal carcinomatosis from breast cancer (18/3), and acute lymphocytic leukemia (4/1). There were 11 episodes of painless perineal paresthesia lasting seconds (11%), 2 of them irradiated to gluteus; 1 episode of painful perineal paresthesias lasting 10 minutes (1%). No complications or adverse events were observed on 88 procedures. Post-PL headache was reported on 3/3 administrations/patients.

Conclusions There was a low rate of side effects, all minor and with full resolution. The IT-ChT technique here described was safe.

Authors/Disclosures
PRESENTER	No disclosure on file
	No disclosure on file
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	No disclosure on file
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	No disclosure on file
Maria Caffaro	No disclosure on file
	No disclosure on file
	No disclosure on file
Ignacio F. Casas-Parera, MD, PhD, FAAN	Dr. Casas-Parera has received publishing royalties from a publication relating to health care.

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