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Вопросы гематологии/онкологии и иммунопатологии в педиатрии. 2015; 14: 5-9

Резервуар Оммайя для проведения интравентрикулярной химиотерапии у детей с нейроонкологическими и онкогематологическими заболеваниями: история создания, техника постановки и опыт Федерального научно-клинического центра детской гематологии, онкологии и иммунологии им. Дмитрия Рогачева Минздрава России

Озеров Сергей Сергеевич, Мельников Андрей Викторович, Самарин Алексей Евгеньевич, Терещенко Галина Викторовна, Кумирова Элла Вячеславовна, Мякова Наталья Валерьевна, Грачев Николай Сергеевич, Желудкова Ольга Григорьевна

https://doi.org/10.24287/1726-1708-2015-14-4-5-9

Аннотация

Резервуар Оммайя является удобным и надежным портом для внутрижелудочкового введения химиопрепаратов у больных с онкогематологическими и нейроонкологическими заболеваниями. В Федеральном научно-клиническом центре детской гематологии, онкологии и иммунологии им. Дмитрия Рогачева Минздрава России (Москва) с 2012 по 2015 г. было установлено 45 резервуаров Оммайя у 45 больных. В большинстве случаев операцию проводили стереотаксически в связи с небольшими размерами желудочковой системы. Интравентрикулярное введение метотрексата обеспечивает высокую и устойчивую концентрацию препарата в ликворе и является хорошей альтернативой эндолюмбальному пути введения. В случае развития гидроцефалии резервуар Оммайя может быть скомбинирован с регулируемой шунтирующей системой, что обеспечивает высокую концентрацию метотрексата в ликворе и безопасность для больного.
Список литературы

1. Sandberg DI, Bilsky MH, Souweidane MM, Bzdil J, Gutin PH. Ommaya reservoirs for the treatment of leptomeningeal metastases. Neurosurgery. 2000;47(1):49-54; discussion 54-5.

2. Bleyer WA, Poplack DG, Simon RM. "Concentration x time" methotrexate via a subcutaneous reservoir: a less toxic regimen for intraventricular chemotherapy of central nervous system neoplasms. Blood. 1978; 51(5): 835-42.

3. Yoshida S, Morii K. Intrathecal chemotherapy for patients with meningeal carcinomatosis. Surg Neurol. 2005; 63(1): 52-5; discussion 55.

4. Holley J. Ayub K. Ommaya, 78; Neurosurgeon and authority on brain injuries. Washington Post. Monday, July 14, 2008.

5. Stieglitz LH, Giordano M, Samii M, Luedemann WO. A new tool for frameless stereotactic placement of ventricular catheters. Neurosurgery. 2010; 67 (3, Suppl Operative): ons131-5; discussion ons135.

6. Whitehead WE, Jea A, Vachhrajani S, Kulkarni AV, Drake JM. Accurate placement of cerebrospinal fluid shunt ventricular catheters with real-time ultrasound guidance in older children without patent fontanelles. J Neurosurg. 2007; 107(5, Suppl): 406-10.

7. Горожанин АВ, Вакатов ДВ, Шестаков АА. Навигационные безрамные системы. В кн.: Древаль О.Н., ред. Нейрохирургия. Т. 1: М.: ГЭОТАР-Медиа, 2012; 477-524.

8. Roth J, Beni-Adani L, Biyani N, Constantini S. Classical and real-time neuronavigation in pediatric neurosurgery. Childs Nerv Syst. 2006; 22(9): 1065-71.

9. Balis FM, Blaney SM, McCully CL, Bacher JD, Murphy RF, Poplack DG. Methotrexate distribution within the subarachnoid space after intraventricular and intravenous administration. Cancer Chemother Pharmacol. 2000; 45(3): 259-64.

10. Poplack DG, Bleyer WA, Wood JH, Kostolich M, Savitch JL, Ommaya AK. A primate model for study of methotrexate pharmacokinetics in the central nervous system. Cancer Res. 1977; 37(7, Pt 1): 1982-5.

11. Shapiro WR, Young DF, Mehta BM. Methotrexate: distribution in cerebrospinal fluid after intravenous, ventricular and lumbar injections. N Engl J Med. 1975; 293(4): 161 -6.

12. Zada G, Chen TC. A novel method for administering intrathecal chemotherapy in patients with leptomeningeal metastases and shunted hydrocephalus: case report. Neurosurgery. 2010; 67(3, Suppl Operative): onsE306-7; discussion onsE307.

Pediatric Hematology/Oncology and Immunopathology. 2015; 14: 5-9

Ommaya reservoir for intraventricular chemotherapy of children with neuro-oncological and oncohematological diseases: Design history, implantation technology, and experience gained at the Federal Research Center of Pediatric Hematology, Oncology, and Immunology named after Dmitry Rogachev

Ozerov S. S., Melnikov A. V., Samarin A. E., Tereshchenko G. V., Kumirova E. V., Myakova N. V., Grachev N. S., Zheludkova O. G.

https://doi.org/10.24287/1726-1708-2015-14-4-5-9

Abstract

Ommaya reservoir is a convenient and reliable port for intraventricular injection of chemotherapeutic drugs in patients with oncohematological and neuro-oncological diseases. A total of 45 Ommaya reservoirs were implanted in 45 patients at the Federal Research Center of Pediatric Hematology, Oncology, and Immunology named after Dmitry Rogachev (Moscow) in 2012-2015. Because of small ventricles in most cases Ommaya reservoirs were implanted by stereotactic procedure. Intraventricular injection of methotrexate supported a high and stable concentration of the drug in the cerebrospinal fluid and proved to be a good alternative to intrathecal administration. In hydrocephalus Ommaya reservoir could be combined with pressure-regulated ventriculoperitoneal shunt, this providing a high concentration of methotrexate in the cerebrospinal fluid, safe for the patient.
References

1. Sandberg DI, Bilsky MH, Souweidane MM, Bzdil J, Gutin PH. Ommaya reservoirs for the treatment of leptomeningeal metastases. Neurosurgery. 2000;47(1):49-54; discussion 54-5.

2. Bleyer WA, Poplack DG, Simon RM. "Concentration x time" methotrexate via a subcutaneous reservoir: a less toxic regimen for intraventricular chemotherapy of central nervous system neoplasms. Blood. 1978; 51(5): 835-42.

3. Yoshida S, Morii K. Intrathecal chemotherapy for patients with meningeal carcinomatosis. Surg Neurol. 2005; 63(1): 52-5; discussion 55.

4. Holley J. Ayub K. Ommaya, 78; Neurosurgeon and authority on brain injuries. Washington Post. Monday, July 14, 2008.

5. Stieglitz LH, Giordano M, Samii M, Luedemann WO. A new tool for frameless stereotactic placement of ventricular catheters. Neurosurgery. 2010; 67 (3, Suppl Operative): ons131-5; discussion ons135.

6. Whitehead WE, Jea A, Vachhrajani S, Kulkarni AV, Drake JM. Accurate placement of cerebrospinal fluid shunt ventricular catheters with real-time ultrasound guidance in older children without patent fontanelles. J Neurosurg. 2007; 107(5, Suppl): 406-10.

7. Gorozhanin AV, Vakatov DV, Shestakov AA. Navigatsionnye bezramnye sistemy. V kn.: Dreval' O.N., red. Neirokhirurgiya. T. 1: M.: GEOTAR-Media, 2012; 477-524.

8. Roth J, Beni-Adani L, Biyani N, Constantini S. Classical and real-time neuronavigation in pediatric neurosurgery. Childs Nerv Syst. 2006; 22(9): 1065-71.

9. Balis FM, Blaney SM, McCully CL, Bacher JD, Murphy RF, Poplack DG. Methotrexate distribution within the subarachnoid space after intraventricular and intravenous administration. Cancer Chemother Pharmacol. 2000; 45(3): 259-64.

10. Poplack DG, Bleyer WA, Wood JH, Kostolich M, Savitch JL, Ommaya AK. A primate model for study of methotrexate pharmacokinetics in the central nervous system. Cancer Res. 1977; 37(7, Pt 1): 1982-5.

11. Shapiro WR, Young DF, Mehta BM. Methotrexate: distribution in cerebrospinal fluid after intravenous, ventricular and lumbar injections. N Engl J Med. 1975; 293(4): 161 -6.

12. Zada G, Chen TC. A novel method for administering intrathecal chemotherapy in patients with leptomeningeal metastases and shunted hydrocephalus: case report. Neurosurgery. 2010; 67(3, Suppl Operative): onsE306-7; discussion onsE307.