Bleyer W A, Poplack D G
Med Pediatr Oncol. 1979;6(3):207-13. doi: 10.1002/mpo.2950060304.
Ten children had recurrence of central-nervous-system (CNS) leukemia despite monthly injections of methotrexate into their lumbar cerebrospinal fluid. Each child was then reinduced into remission and maintained with intraventricular methotrexate administered via an Ommaya reservoir and the length of this remission was compared with the duration of the child's previous intralumbar-treated remission. Of eight evaluable patients, seven had longer CNS remissions with intraventricular therapy than with intralumbar therapy (P less than 0.02). The median CNS remission duration in all patients was 475 days with intraventricular and 286 days with intralumbar therapy (P less than 0.05). The rate of CNS relapse was reduced from 2.94 relapses per thousand days at risk during intralumbar therapy to 0.93 relapse per thousand days of intraventricular therapy. We conclude that intraventricular chemotherapy is significantly more effective against CNS leukemia than the same therapy given by lumbar puncture.
尽管每月向腰椎脑脊液中注射甲氨蝶呤，仍有10名儿童出现中枢神经系统（CNS）白血病复发。然后，让每个儿童再次诱导缓解，并通过奥马亚贮液器进行脑室内甲氨蝶呤维持治疗，并将此次缓解的时长与该儿童之前经腰椎治疗的缓解期时长进行比较。在8名可评估的患者中，7名患者脑室内治疗的中枢神经系统缓解期比腰椎内治疗的更长（P小于0.02）。所有患者中枢神经系统缓解期的中位数，脑室内治疗为475天，腰椎内治疗为286天（P小于0.05）。中枢神经系统复发率从腰椎内治疗期间每千日风险2.94次复发降至脑室内治疗每千日0.93次复发。我们得出结论，脑室内化疗对中枢神经系统白血病的疗效明显优于通过腰椎穿刺进行的相同治疗。
