Postoperative intracavitary chemotherapy of malignant gliomas

Abstract

✓ In eight patients with malignant gliomas of the hemisphere and one with metatastic carcinoma, high doses of methotrexate were injected through an indwelling catheter into the bed of the tumor after craniotomy. Up to 1250 mg of this cystostatic agent were given in single daily doses over periods of 4 to 10 days. There were few local reactions to the injections, but despite systemic folinic acid treatment, two patients developed transient leukopenia. Clinical and pathological follow-up showed that necrosis developed in the superficial parts of the tumor. It was found possible to leave an ordinary catheter in a postoperative tumor cavity for as long as 44 days. This technique appears to be a valuable adjunct to the treatment of cerebral tumors with cytotoxic drugs since it does not necessitate exposure of other body tissues to the chemotherapeutic agents.