intrathecal chemotherapy
The distinction between the two different leptomeningeal tumor spreading patterns described above has an impact on the indication for an intrathecal chemotherapy:
- (i) the intrathecally administered chemotherapy reaches the free-floating non-adherent tumor cells or cell clusters of the diffuse, non-adherent type well. A disturbance of the CSF flow does not exist.
- (ii) The nodular type is characterized by contrast enhancing leptomeningeal tumor nodules. It is important to note, that intrathecal therapy may probably not sufficiently reach malignant cells in tumor nodules with a diameter greater than 2–4 mm
