Current treatment approaches for neoplastic meningitis: nursing management of patients receiving intrathecal DepoCyt.
OBJECTIVE
To review neoplastic meningitis and the nursing implications for the intrathecal administration of chemotherapy.


METHODS
Published research and educational manuscripts, books, conference proceedings, and personal experience.


RESULTS
Standard treatment for neoplastic meningitis includes radiotherapy to the neuraxis to palliate symptomatic disease, intrathecal chemotherapy to eradicate cancer cells in the cerebrospinal axis, and systemic chemotherapy. Intrathecal liposomal cytarabine (DepoCyt), a novel lipid-encapsulated chemotherapeutic agent, prolongs tumor exposure to cytotoxic levels of cytarabine, improves patient response rates, and prolongs time to clinical progression.


CONCLUSIONS
DepoCyt prolongs the half-life of cytarabine in the central nervous system, resulting in improved patient response to therapy and delayed disease progression.


CONCLUSIONS
The clinical success of DepoCyt treatment depends on effective implementation of the treatment regimen, attentiveness to patient and family education, and adverse-event management.
Craig
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C
Pharmaceutical Research Associates, International, Charlottesville, VA, USA. craigcatherine@praintl.com
D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage* / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000150:complications / Q000188:drug therapy / Q000473:pathology; D003131:Combined Modality Therapy / Q000451:nursing; D003561:Cytarabine / Q000008:administration & dosage* / Q000627:therapeutic use; D003692:Delayed-Action Preparations; D018450:Disease Progression; D004509:Education, Nursing, Continuing; D006801:Humans; D007278:Injections, Spinal / Q000451:nursing; D008577:Meningeal Neoplasms / Q000188:drug therapy* / Q000451:nursing* / Q000473:pathology / Q000556:secondary; D008578:Meninges / Q000473:pathology; D009859:Oncology Nursing; D010353:Patient Education as Topic; D011788:Quality of Life
D000964:Antimetabolites, Antineoplastic; D003692:Delayed-Action Preparations; D003561:Cytarabine