EAPH-11. INTRAVENTRICULAR THERAPY ALTERNATING ETOPOSIDE, AQUEOUS CYTARABINE AND TOPOTECAN IS FEASIBLE AND SAFE: EXPERIENCE IN 26 PEDIATRIC PATIENTS WITH MALIGNANT BRAIN TUMORS

BACKGROUND: Malignant brain tumors carry a high risk for leptomeningeal dissemination, but tumor cells floating in the CSF are often not affected by systemic and/or antiangiogenic chemotherapy. Since liposomal cytarabine was removed from the market, alternatives for intraventricular therapy are desperately needed. We report on our experience with an intraventricular therapy consisting of alternating cycles of etoposide, aqueous cytarabine and topotecan. PATIENTS AND METHODS: Between 2008 and 2017, 26 patients aged 1 to 17 years (median 7 years) with various malignant brain tumors received intraventricular therapy via an Ommaya reservoir, consisting of alternating etoposide 0.5mg on five consecutive days (1 and 2 and 1 and 2 and