Objective  To investigate the efficacy, security and prognosis of intrathecal injection of methotrexate (MTX) in treatment of meninges carcinoma.

  Methods  Clinical data of 22 meninges carcinoma patients treated by intrathecal injection of MTX were retrospectively reviewed, and the clinical efficacy, adverse events as well as prognosis after intrathecal chemotherapy were analyzed.

  Results  All 22 patients were treated by intrathecal injection of MTX, 14 patients(63.9%)with headache and 3 patients (13.6%)with mental and behavior disorder improved after treatment. Six patients had adverse events in the course of intrathecal injection, among whom five patients had nerve root irritation and one patient suffered grade III myelosuppression. Cerebrospinal fluid (CSF) cytology reexamination showed that CSF tumor cells were negative in 8 patients. However, there were no significant differences in the changes of cerebrospinal fluid protein, glucose and chloride before and after intrathecal injection(P>0.05). Cox regression analysis showed that Karnofsky Performance Scale (KPS) score and tyrosine kinase inhibitor (TKI) therapy were prognostic influencing factors.

  Conclusion  Intrathecal administration of MTX can partially improve the clinical symptoms of meninges carcinoma patients with no severe adverse events observed. Intrathecal injection for chemotherapy is a reliable treatment of meninges carcinoma.