Is intrathecal methotrexate necessary in the treatment of primary CNS lymphoma?

J Neurooncol. 2002 Jun;58(2):175-8. doi: 10.1023/a:1016077907952.

Abstract

Systemic high-dose methotrexate (HD-MTX) is the most effective chemotherapeutic agent in the treatment of primary central nervous system lymphoma (PCNSL). Leptomeningeal involvement is common and intrathecal methotrexate (IT-MTX) is frequently used in combination with HD-MTX, but its benefits are not established. Using a case-controlled retrospective study, matching patients treated with HD-MTX with or without IT-MTX, we found no difference in survival, disease control, or neurotoxicity.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antimetabolites, Antineoplastic / administration & dosage*
  • Antimetabolites, Antineoplastic / adverse effects
  • Antimetabolites, Antineoplastic / therapeutic use
  • Case-Control Studies
  • Central Nervous System Neoplasms / drug therapy*
  • Dose-Response Relationship, Drug
  • Female
  • Humans
  • Injections, Spinal
  • Lymphoma / drug therapy*
  • Male
  • Methotrexate / administration & dosage*
  • Methotrexate / adverse effects
  • Methotrexate / therapeutic use
  • Middle Aged
  • Nervous System / drug effects
  • Retrospective Studies
  • Survival Analysis
  • Treatment Outcome

Substances

  • Antimetabolites, Antineoplastic
  • Methotrexate