Evidence map›Paper›PMID 42234048›Full record

SynthesisJournal of neuro-oncology2026

A comparative study of Ommaya reservoir versus lumbar puncture for intrathecal chemotherapy in patients with leptomeningeal metastasis: a systematic review and meta-analysis.

Lushao Zhang, Mingtao Feng, Yuechao Yang, Zhe Qi, Pokharel Bihani, Kazmi Sabrina Shah, Yu Xuan Ong, Kexuan Wang, Yiqun Cao, Liangdong Li and 1 more

Abstract readSystematic ReviewMeta-AnalysisComparative Study
In one paragraph

Synthesis in Journal of neuro-oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Lushao Zhang *Department of Neurosurgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.
Mingtao Feng *Department of Neurosurgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.
Yuechao Yang *Department of Neurosurgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.
Zhe QiDepartment of Neurosurgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.
Pokharel BihaniDepartment of Neurosurgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.
Kazmi Sabrina ShahDepartment of Neurosurgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.
Yu Xuan OngDepartment of Neurosurgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.
Kexuan WangDepartment of Neurosurgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.
Yiqun CaoDepartment of Neurosurgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China. yiqun_fduscc@163.com.
Liangdong LiDepartment of Neurosurgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China. lild0123@163.com.
Yang GaoDepartment of Neurosurgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China. dryanggao@126.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLeptomeningeal metastasis (LM) is a lethal complication of advanced malignancy with limited therapeutic options and poor survival. Intrathecal chemotherapy represents a standard treatment for LM and can be administered via repeated lumbar puncture (LP) or an intraventricular Ommaya reservoir. However, the comparative efficacy and safety of these two administration routes remain unclear. This study aims to compare the clinical outcomes of intrathecal chemotherapy delivered by Ommaya reservoir versus LP in patients with LM, and to provide further evidence for clarifying the advantages of the Ommaya reservoir in clinical practice.

methodsWe systematically searched PubMed, Embase and Web of Science for relevant studies published between 1986 and 2026. Studies directly comparing intrathecal chemotherapy delivered via Ommaya reservoir and LP were included in the meta-analysis. Disease control rate (DCR) was pooled as odds ratios (OR) using a random-effects Mantel-Haenszel model to account for between-study heterogeneity, and overall survival (OS) was pooled as hazard ratios (HR) using the inverse-variance method. Because adverse events (AEs) were incompletely reported in comparative studies, an additional safety analysis including single-arm cohorts was conducted using a binomial generalized linear mixed model (GLMM) with a logit link. Risk of bias was assessed using the ROBINS-I tool.

resultsA total of four comparative studies with a moderate overall risk of bias were included in our meta-analysis. Three studies contributed data on DCR, and three studies contributed data on OS. The pooled analysis showed no significant difference in DCR between the Ommaya and LP groups (OR 2.03; 95% CI 0.53-7.78, p = 0.30), with moderate heterogeneity (I² = 66%). In contrast, Ommaya-based intraventricular delivery was associated with significantly improved OS compared with LP (HR 0.39; 95% CI, 0.25-0.61, p < 0.0001), with no significant heterogeneity (I² = 0%). In the exploratory safety analysis of six single-arm cohorts, the estimated probability of overall AEs was numerically lower in the Ommaya group (OR 0.43; 95% CI, 0.21-0.87, p = 0.0191). While this finding is derived from non-comparative data and should be treated cautiously, it offers valuable insight into safety profile.

conclusionOmmaya reservoir-based intraventricular administration of intrathecal chemotherapy may provide a survival advantage over LP in patients with LM, while demonstrating a generally acceptable and manageable safety profile. Further comparative studies with standardized response criteria and rigorous safety reporting are warranted.

Indexed as

Antineoplastic AgentsMeningeal CarcinomatosisMeningeal NeoplasmsSpinal PunctureHumansInjections, SpinalAntineoplastic AgentsIntrathecal chemotherapyLeptomeningeal metastasisLumbar punctureMeta-analysisOmmaya reservoirOverall survival

Identifiers

PMID42234048
PMCPMC13233974

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.