Neoplastic Meningitis from a Pineal Tumour Treated by Antibody-guided Irradiation via the Intrathecal Route

H. B. Coakham Departments of Neurosurgery, Medical Physics and, Brain Tumour Research Laboratory, Frenchay Hospital, Bristol, The Bristol Radiotherapy and Oncology Centre and The Imperial Cancer Research Fund Oncology Laboratory, Institute of Child Health, London, United Kingdom

R. B. Richardson Departments of Neurosurgery, Medical Physics and, Brain Tumour Research Laboratory, Frenchay Hospital, Bristol, The Bristol Radiotherapy and Oncology Centre and The Imperial Cancer Research Fund Oncology Laboratory, Institute of Child Health, London, United Kingdom

A. G. Davies Departments of Neurosurgery, Medical Physics and, Brain Tumour Research Laboratory, Frenchay Hospital, Bristol, The Bristol Radiotherapy and Oncology Centre and The Imperial Cancer Research Fund Oncology Laboratory, Institute of Child Health, London, United Kingdom

S. P. Bourne Departments of Neurosurgery, Medical Physics and, Brain Tumour Research Laboratory, Frenchay Hospital, Bristol, The Bristol Radiotherapy and Oncology Centre and The Imperial Cancer Research Fund Oncology Laboratory, Institute of Child Health, London, United Kingdom

H. Eckert Departments of Neurosurgery, Medical Physics and, Brain Tumour Research Laboratory, Frenchay Hospital, Bristol, The Bristol Radiotherapy and Oncology Centre and The Imperial Cancer Research Fund Oncology Laboratory, Institute of Child Health, London, United Kingdom

J. T. Kemshead Departments of Neurosurgery, Medical Physics and, Brain Tumour Research Laboratory, Frenchay Hospital, Bristol, The Bristol Radiotherapy and Oncology Centre and The Imperial Cancer Research Fund Oncology Laboratory, Institute of Child Health, London, United Kingdom

Abstract

A monoclonal antibody (UJ181.4) was labelled with ¹³¹I and given intrathecally to a patient who was critically ill with neoplastic meningitis due to a disseminated pineoblastoma. The target antigen had first been demonstrated on tumour cells by immunocytological testing of cerebrospinal fluid (CSF). As a preparation for therapy, a test dose of ^13II-UJ181.4 antibody was given simultaneously with a control antibody labelled with ¹²⁵I. Good evidence of in vivo immunolocalisation was obtained by external gamma counting and by analysis of the radiolabels on centrifuged CSF cells. Specificity ratios of between 10:1 and 20:1 were obtained by these methods. A single relatively small therapeutic dose of ¹³¹-I (870 MBq) given by the intrathecal route, resulted in a marked clinical improvement and sustained remission for 22 months.

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Neoplastic Meningitis from a Pineal Tumour Treated by Antibody-guided Irradiation via the Intrathecal Route

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Neoplastic Meningitis from a Pineal Tumour Treated by Antibody-guided Irradiation via the Intrathecal Route

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