Nagai M
Dept. of Neurosurgery, Dokkyo University School of Medicine.
Gan To Kagaku Ryoho. 1989 Feb;16(2):156-64.
Intrathecal chemotherapy is inevitable method for the treatment of seeding of malignant brain tumors which appears in high incidence. The therapy is performed by means of lumbar tap, intraventricular or intratumorous administration, or ventriculo-cisternal perfusion. The same methods are applied to the treatment of original tumor mass as well. The main drugs used for the therapy are methotrexate and cytosine arabinoside. The causes of limitations of the method are the adverse effects of drugs and their short distance of diffusion penetrating into the tumor tissue. Local or intrathecal administration of Interferon could be reached high levels in the cerebrospinal fluid without severe side-effect. 7 out of 22 cases (31.8%) of malignant glioma responded to the local therapy with Interferon. Intrathecal Interferon therapy also revealed marked effect on the disseminated medulloblastoma. Intrathecal therapy should become much more important method including application to the immunotherapy in the future.
鞘内化疗是治疗高发性恶性脑肿瘤播散的必然方法。该治疗通过腰椎穿刺、脑室内或瘤内给药，或脑室-脑池灌注进行。同样的方法也应用于原发性肿瘤肿块的治疗。治疗主要使用的药物是甲氨蝶呤和阿糖胞苷。该方法存在局限性的原因是药物的不良反应及其向肿瘤组织扩散渗透的距离较短。局部或鞘内给予干扰素可在脑脊液中达到较高水平且无严重副作用。22例恶性胶质瘤患者中有7例（31.8%）对干扰素局部治疗有反应。鞘内干扰素治疗对播散性髓母细胞瘤也显示出显著效果。鞘内治疗在未来应成为包括免疫治疗应用在内的更为重要的方法。
