title: [Treatment of multiple or recurrent intracranial tumors with local chemotherapy by hypodermic Ommaya reservoir].
abstract: OBJECTIVE
  To explore the treatment of multiple or recurrent intracranial tumors by hypodermic placement of Ommaya reservoir and local chemotherapy with methotrexate.
  
  
  METHODS
  Retrospective analyses were performed on the clinical data of 45 cases with multiple or recurrent intracranial tumors at Friendship Affiliated Hospital, Capital Medical University from January 2010 to September 2013. All 45 cases had a placement of Ommaya reservoir under skin. Shunt tubes were placed in ventricle (n = 41), cystic tumor cavity (n = 3) and tumor cavity (n = 1). Methotrexate was injected postoperatively into Ommaya reservoir by transcutaneous paracentesis.
  
  
  RESULTS
  After local chemotherapy, head magnetic resonance imaging (MRI) re-examinations were performed. Tumors disappeared (n = 32), shrunk significantly (n = 10) and had no significant improvement of symptoms with spinal implantation metastasis (n = 1). During chemotherapy, there were two mortalities due to septic shock and heart failure (n = 1 each). Follow-ups were conducted for 32 cases and 7 of them died. One case had operation-related complications. After an adjustment of shunt tube, symptoms and signs improved. And after local chemotherapy, tumor disappeared on MRI.
  
  
  CONCLUSIONS
  The placement of Ommaya reservoir is mini-invasive and well-tolerated. And local chemotherapy with methotrexate by Ommaya reservoir is convenient and it may reduce systemic side effects, improve the efficacy of chemotherapy drugs, prolong survival time and enhance quality of life.
authors.affiliation: Department of Neurosurgery, Affiliated Friendship Hospital, Capital Medical University, Beijing 100050, China. Email: 13910178021@139.com.
authors.forename: Jing
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Neurosurgery, Affiliated Friendship Hospital, Capital Medical University, Beijing 100050, China.
authors.forename: Zang
authors.initials: Z
authors.lastname: Liu
authors.affiliation: Department of Neurosurgery, Affiliated Friendship Hospital, Capital Medical University, Beijing 100050, China.
authors.forename: Ruiguang
authors.initials: R
authors.lastname: Hou
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000188:drug therapy*; D002408:Catheters, Indwelling; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage* / Q000627:therapeutic use; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D008727:Methotrexate