Intrathecal liposomal cytarabine and leptomeningeal medulloblastoma relapse: A valuable therapeutic option

Background: Relapsed medulloblastoma (MB) is a highly lethal disease, requiring for new effective treatment strategies. Intrathecal (IT) therapy both for de novo or relapsed brain tumors with meningeal metastasis is rarely used in first line and relapse protocols. Patients and Methods: We report on three cases of children with relapsed MB treated with IT liposomal cytarabine administered after mild sedation every 15 days. Results: The treatment was well-tolerated in all patients, achieving a prolonged progression-free survival (4- 11 months) with a good quality of life. Conclusion: This experience suggests the need for a phase II trial in brain embryonal tumors with leptomeningeal metastasis to better evaluate the efficacy of IT liposomal cytarabine.