intrathecal chemotherapy
Direct administration of anticancer drugs into the cerebrospinal fluid via lumbar puncture or Ommaya reservoir.
Full Definition
Intrathecal chemotherapy involves the direct instillation of chemotherapeutic agents into the cerebrospinal fluid (CSF) through lumbar puncture or an implanted Ommaya reservoir. This route of administration bypasses the blood-brain barrier, allowing therapeutic drug concentrations to be achieved in the central nervous system. Common agents used include methotrexate, cytarabine (ara-C), and thiotepa, either as single agents or in combination (such as triple intrathecal therapy). Indications include CNS prophylaxis in high-risk leukemia or lymphoma, treatment of established CNS disease, or as part of preparative regimens for stem cell transplantation. Complications can include chemical meningitis, seizures, and rarely, paraplegia from inadvertent administration of vincristine intrathecally.
Usage
Usage note: Never use vincristine intrathecally—this is a fatal error; ensure proper verification procedures for intrathecal medications.
In Context
- "Intrathecal chemotherapy was administered via lumbar puncture under sedation." — Procedure note
- "The Ommaya reservoir allowed for convenient intrathecal chemotherapy delivery." — Neurosurgical consultation