Vol 6, No 3 (2010)
Review paper
Published online: 2010-08-27
The modern diagnosis and intrathecal therapy of the neoplastic meningitis in adults solid neoplasms
Onkol. Prak. Klin 2010;6(3):97-103.
Abstract
Nowadays there are more recognized rare oncologic cases because of introducing sophisticated diagnostic
methods to everyday clinical practice. The example of this is the neoplastic meningitis. This in
turn augments the development of better therapeutic procedures. In the diagnostic sector, to well-known
tools such as myelo-KT, nuclear magnetic resonance (NMR), lumbar puncture with cytologic and biochemical
examination of the fluid or flow scintigraphy of the cerebrospinal fluid, came to existence new
devices like positron emission tomography (PET) and specific chemical substances tests in the fluid, connected
with the presence of the exact oncologic entity (Ca 15.3, LDH, angiogenesis markers, interleukins).
The new therapeutic options are directly connected with improved diagnostic methods of the central nervous system. The liposomal formulations of the previously used cytotoxic drugs for intrathecal therapy emerged (methotrexat, cytarabine), which have improved central nervous system penetration ability and their longer life half-time prolongs the time to the next lumbar puncture. There are introduced completely new substances so called immunomodulators (trastuzumab, rituximab, interferons), which aim selectively for neoplastic cells.
Those aforementioned improvements prolonged the life time of the neoplastic meningitis patients and increased its quality. But there is a constant demand for improving current methods and exploring new approaches.
Onkol. Prak. Klin. 2010; 6, 3: 97–103
The new therapeutic options are directly connected with improved diagnostic methods of the central nervous system. The liposomal formulations of the previously used cytotoxic drugs for intrathecal therapy emerged (methotrexat, cytarabine), which have improved central nervous system penetration ability and their longer life half-time prolongs the time to the next lumbar puncture. There are introduced completely new substances so called immunomodulators (trastuzumab, rituximab, interferons), which aim selectively for neoplastic cells.
Those aforementioned improvements prolonged the life time of the neoplastic meningitis patients and increased its quality. But there is a constant demand for improving current methods and exploring new approaches.
Onkol. Prak. Klin. 2010; 6, 3: 97–103
Keywords: intrathecal therapyneoplastic meningitisPET
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