Chemotherapy For Specific Areas Of The Body (Regional Chemotherapy)

Intrathecal chemotherapy is given directly into the fluid surrounding the brain and spinal cord (cerebrospinal fluid or CSF) to reach cancer cells in the fluid and around the central nervous system. Most chemotherapy drugs that are given into veins are unable to cross the barrier between the bloodstream and the central nervous system (brain and spinal cord), called the blood-brain barrier.

Intrathecal chemotherapy is given by one of two methods:

• The chemotherapy is given by a lumbar puncture (spinal tap) daily or weekly into the space around the spinal cord.

• The second method uses a special device called an Ommaya reservoir, which is placed into the skull and has a catheter inserted into a ventricle (a space inside the brain filled with cerebrospinal fluid).

Chemotherapy is given this way when it is needed to treat cancer cells that have entered the central nervous system (this is called leptomeningeal spread). It is seen most commonly in leukemias, but also may happen with some lymphomas and advanced solid tumors like breast and lung cancers.

Intrathecal chemotherapy does not help when tumors have already started growing in the brain or spinal cord.

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