{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T12:12:31Z","timestamp":1778501551074,"version":"3.51.4"},"reference-count":11,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T00:00:00Z","timestamp":1778457600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T00:00:00Z","timestamp":1778457600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100004375","name":"Tel Aviv University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004375","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Childs Nerv Syst"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Current chemotherapy protocols for treatment of embryonal brain tumors in children may recommend administration of intrathecal chemotherapy, either by a lumbar tap or via an Ommaya reservoir. Children with concurrent hydrocephalus and shunts may have subtherapeutic levels of chemotherapy in the CSF due to constant CSF drainage to extra-CNS compartments. We present our experience in delivery of chemotherapy to children via programmable valves.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective analysis of children with CNS malignancies together with hydrocephalus treated with a shunt and a programmable valve (CERTAS\u2122 Plus Programmable Valves\u2014Integra Life Sciences, proGAV\u00ae\u2014Miethke) was conducted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Eighteen children up to 16\u00a0years of age (mean age 5\u00a0years) were included. Main pathologies included medulloblastomas (7) and atypical rhabdoid teratoid tumor (5). Each patient underwent 3\u201355 intrathecal injections (17\u2009\u00b1\u200914). One patient developed symptomatic hydrocephalus during the injection, which resolved with valve resetting. There were no infections, leaks, or major complications. One child required a wound revision due to exposure of the proximal catheter related to extremely thin skin. One patient experienced a \u201cstuck\u201d setting of the valve. Eight children are alive with no active disease, 25\u201380\u00a0months after shunt placement (52\u2009\u00b1\u200921). There were no late effects related to IT chemotherapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Programmable ventriculoperitoneal valves are a safe method for delivery of intra-ventricular chemotherapy in children. This technique may potentially have an added value for children with concurrent shunts and may also obviate the need for an additional ventricular access device (such as an Ommaya reservoir).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00381-026-07311-y","type":"journal-article","created":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T11:39:51Z","timestamp":1778499591000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Programmable shunt valves with a \u201cvirtual off\u201d for intrathecal chemotherapy delivery in children with high-grade CNS tumors and hydrocephalus"],"prefix":"10.1007","volume":"42","author":[{"given":"Rina","family":"Dvir","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yair","family":"Peled","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dror","family":"Levin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ronit","family":"Elhasid","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shlomi","family":"Constantini","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manina Maja","family":"Etter","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jehuda","family":"Soleman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valentina","family":"Pennacchietti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ulrich-Wilhelm","family":"Thomale","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"Roth","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,5,11]]},"reference":[{"key":"7311_CR1","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1007\/s11060-014-1531-1","volume":"120","author":"A Peyrl","year":"2014","unstructured":"Peyrl A, Chocholous M, Azizi AA et al (2014) Safety of Ommaya reservoirs in children with brain tumors: a 20-year experience with 5472 intraventricular drug administrations in 98 patients. J Neurooncol 120:139\u2013145. https:\/\/doi.org\/10.1007\/s11060-014-1531-1","journal-title":"J Neurooncol"},{"key":"7311_CR2","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.26754","author":"K Kramer","year":"2018","unstructured":"Kramer K, Pandit-Taskar N, Humm JL et al (2018) A phase II study of radioimmunotherapy with intraventricular 131I-3F8 for medulloblastoma. Pediatr Blood Cancer. https:\/\/doi.org\/10.1002\/pbc.26754","journal-title":"Pediatr Blood Cancer"},{"key":"7311_CR3","doi-asserted-by":"publisher","first-page":"457","DOI":"10.1007\/s11060-022-03989-7","volume":"157","author":"SS McThenia","year":"2022","unstructured":"McThenia SS, Pandit-Taskar N, Grkovski M et al (2022) Quantifying intraventricular drug delivery utilizing programmable ventriculoperitoneal shunts as the intraventricular access device. J Neurooncol 157:457\u2013463. https:\/\/doi.org\/10.1007\/s11060-022-03989-7","journal-title":"J Neurooncol"},{"key":"7311_CR4","doi-asserted-by":"publisher","DOI":"10.4103\/2152-7806.139381","author":"SK Palejwala","year":"2014","unstructured":"Palejwala SK, Stidd DA, Skoch JM et al (2014) Use of a stop-flow programmable shunt valve to maximize CNS chemotherapy delivery in a pediatric patient with acute lymphoblastic leukemia. Surg Neurol Int. https:\/\/doi.org\/10.4103\/2152-7806.139381","journal-title":"Surg Neurol Int"},{"key":"7311_CR5","doi-asserted-by":"publisher","DOI":"10.3390\/jcm7080216","author":"MC Burger","year":"2018","unstructured":"Burger MC, Wagner M, Franz K et al (2018) Ventriculoperitoneal shunts equipped with on-off valves for intraventricular therapies in patients with communicating hydrocephalus due to leptomeningeal metastases. 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No patient consent was required.\u00a0","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"213"}}