Grand Rounds

Intraventricular Topotecan for the Treatment of Neoplastic Meningitis: Five Case Studies

Julie Walker, RN, FNP-C, AOCNP®, Diana Schultz, RN, MSN, ACNP, Kathleen Grisdale, RN, MSN, FNP-C, and Morris Groves, MD, JD

From The University of Texas MD Anderson Cancer Center, Houston, Texas

The authors have no conflicts of interest to disclose.

Correspondence to: Julie Walker, RN, FNP-C, AOCNP®, 1515 Holcombe Boulevard, Unit 431, Houston, TX 77030. E-mail: jgwalker@mdanderson.org


J Adv Pract Oncol 2012;3:237–241 | DOI: 10.6004/jadpro.2012.3.4.4 | © 2012 Harborside Press®


  

ABSTRACT

Many systemic cytotoxic agents cannot penetrate the blood-brain barrier. Because of this, in approximately 5% of cancer cases, metastatic disease is seen in the leptomeninges. Without treatment, patients with neoplastic meningitis (NM) generally survive for only a matter of weeks. In the treatment of NM, intraventricular (IVT) topotecan results in progression-free and overall survival outcomes similar to those seen with other IVT chemotherapies, while being particularly well tolerated by most patients. In this article, we present the case studies of five patients with NM, with various primary malignancies, who received treatment with IVT topotecan.  




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