Intrathecal Chemothearpy

Intrathecal chemotherapy is provided to patients suffering from cancer of the central nervous system. It is also given to patients who have an increased risk of metastasis of certain cancers, such as lymphoma or acute lymphoblastic leukemia, to the central nervous system. Intrathecal chemotherapy is an effective method to deliver chemotherapy to the brain and spinal cord because the drugs delivered through the oral and injectable route do not reach the central nervous system in therapeutic concentration due to the presence of the blood-brain barrier.

Our Offerings

  • Intrathecal Chemotherapy through Lumbar Puncture: Through a lumbar puncture, the doctor delivers the cancer medications into the cerebrospinal fluid present between the two vertebrae of the lower spine. The doctor may also obtain a CSF sample for further evaluation. A lumbar puncture requires injecting a local anesthetic to numb a small part of the back. The patient should not move or cough while the doctor injects local anesthesia into the spine. The doctor also uses x-rays to guide the needle into the spine. Once the drug is injected, the doctor pulls the needle back and applies the dressing.
  • Intrathecal Chemotherapy through Intraventricular Ommaya Reservoir: Ommaya reservoir is an intraventricular system that establishes access to the intrathecal space for a longer period. This reservoir allows the administration of various drugs, such as antibiotics, anticancer drugs, antifungal medications, and analgesics, directly into the brain. Patients with brain abscesses and scalp infections are not recommended to use the Ommaya reservoir. These devices are implanted under general anesthesia. The patients recommended for Ommaya reservoir implantation for hematological malignancies require the specialized expertise of neurosurgeons, oncologists, neurological nursing teams, and radiologists. After Ommaya reservoir implantation, the patients are under constant monitoring for surgical site redness and swelling or ,meningitis due to the device, and early signs of increased intracranial pressure.


Some of the risks associated with intrathecal chemotherapy through lumbar puncture are:

  • Headache
  • Low blood pressure
  • Minor bruising or pain at the site of the injection
  • Nerve damage
  • Infection at the site of infection
  • Spinal cord injury
  • Cardiac arrest or seizures due to anesthetic toxicity (rare)
  • Failure of local anesthetic action that may require further anesthesia

The doctor advises the patients to lie flat for around 1-2 hours, or until they feel comfortable. The patients may experience a headache after intrathecal therapy. The doctor may prescribe analgesics to relieve headaches. Once the patient feels well, he may get up and move around. However, the patients shouldn't work on machines for at least 24 hours after the procedure. If the patient has multiple sessions of intrathecal chemotherapy, he may undergo a lumbar puncture each time.