Distribution of Etoposide in Cerebrospinal Fluid After Infusions Into the Fourth Ventricle in Piglets

Abstract

Introduction We hypothesize that infusion of chemotherapeutic agents directly into the fourth ventricle may potentially play a role in treating malignant posterior fossa tumors. Previous experiments from our laboratory have demonstrated that etoposide can be administered into the fourth ventricle in piglets without causing neurological deficits or radiographic evidence of damage. The objective of this study was to compare etoposide levels in cerebrospinal fluid (CSF) samples from the fourth ventricle to etoposide levels in CSF samples from the lumbar cistern after such infusions. Methods We inserted a closed-tip silicone lumbar drain catheter into the fourth ventricle in 3 piglets via a posterior fossa craniectomy. In the same 3 piglets, we also inserted a catheter into the lumbar cistern via a limited lumbar laminectomy. Five consecutive daily infusions of etoposide (0.5 mg) were administered via the fourth ventricle catheter. CSF was sampled from both catheters for pharmacokinetic analysis by reversed-p...