Impact of Multimodality Approach for Patients with Leptomeningeal Metastases from Solid Tumors

Kwon, Junhyun; Chie, Eui Kyu; Kim, Kyubo; Kim, Hak Jae; Wu, Hong Gyun; Kim, Il Han; Oh, Do Youn; Lee, Se‐Hoon; Kim, Dong Wan; Im, Seock Ah; Kim, Tae You; Heo, Dae Seog; Bang, Yung Jue; Ha, Sung Whan

doi:10.3346/jkms.2014.29.8.1094

Cited by 23 publications

(13 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although the recent advances in systemic treatment of advanced cancers have resulted in significant improvements in survival, the prognosis of patients with LM remains poor. In this study, the median survival was only 2.4 months (95% CI, 1.0–3.7) in 58 patients with sold tumor who were diagnosed with LM, which is similar to previous reports of LM in patients with solid tumors (1.5 to 4.4 months) [ 6 11 12 ]. A good PS, systemic chemotherapy after LM diagnosis, and a prior history of brain radiation were associated good survival in our patients.…”

Section: Discussionsupporting

confidence: 90%

“…However, in studies on LM from Asian countries, melanomas were rare, and gastric cancer was one of the most common origins of LM in Asia including Korea. [ 6 11 12 ]. In this study, consistent with these Asian reports, breast cancer (39.7%), lung cancer (including NSCLC and small cell lung cancer, 22.4%), and gastric cancer (25.9%) were common causes of LM, and melanoma was reported in only one case.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A Retrospective Analysis of the Clinical Outcomes of Leptomeningeal Metastasis in Patients with Solid Tumors

Kim

Lee

2018

Brain Tumor Res Treat

View full text Add to dashboard Cite

BackgroundLeptomeningeal metastasis (LM) is an uncommon, but devastating complication of advanced cancer and has no standard treatment. Herein, we analyzed the clinical characteristics and outcomes of patients with solid tumors who were diagnosed with LM.MethodsBetween January 2007 and December 2017, we retrospectively analyzed the medical records of patients with solid tumors who were diagnosed with LM.ResultsA total of 58 patients were enrolled in this study. The median age of patients was 51 years (range, 27–72 years), and 62.1% had a poor Eastern Cooperative Oncology Group (ECOG) performance status (PS) (>2). The common types of primary tumor were breast cancer (39.7%), gastric cancer (25.9%), and non-small cell lung cancer (20.7%). Forty-two patients (72.4%) were diagnosed with LM by MRI of the brain and/or spine and cerebrospinal fluid (CSF) analysis, 14 were diagnosed by CSF analysis alone, and 2 were diagnosed by MRI alone. Treatments for LM were performed in 53 patients (91.4%), and best supportive care was provided for 5 patients (8.6%). Intrathecal chemotherapy, radiotherapy, and systemic chemotherapy were administered in 43 (74.1%), 17 (29.3%), and 24 (41.4%) patients, respectively. The median overall survival of the entire cohort was 2.4 months (95% confidence interval, 1.0–3.7). In the analysis of prognostic factors for survival, a good ECOG PS (≤2), administration of systemic chemotherapy after LM diagnosis, and a prior history of brain radiation were associated with prolonged survival.ConclusionAlthough the prognosis of LM in patients with solid tumors is poor, systemic chemotherapy might improve survival in selected patients with a good PS.

show abstract

Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

A Retrospective Analysis of the Clinical Outcomes of Leptomeningeal Metastasis in Patients with Solid Tumors

Kim

Lee

2018

Brain Tumor Res Treat

View full text Add to dashboard Cite

show abstract

“…Studies have shown that although systemic chemotherapy drugs have limited ability to penetrate the blood-brain barrier, the concentration of drugs that can reach the cerebrospinal uid is very low, systemic treatment is thereby not an effective method for the treatment of NM, it is still an independent factor affecting the prognosis of NM patients. Multiple retrospective analyses have shown that systemic chemotherapy can prolong the survival time of patients [29][30][31][32] , and can simultaneously treat active systemic tumors and meningeal lesions. Targeted therapy is a brand-new treatment method.…”

Section: Discussionmentioning

confidence: 99%

6 Cases of Breast Cancer-Associated Neoplastic Meningitis and Literature Review

Fan¹,

Gao²,

He³

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Neoplastic meningitis refers to malignant tumors invading the meninges and subarachnoid spaces, causing intracranial metastases similar to meningitis. Discovery of tumor cells in the cerebrospinal fluid is the gold standard for its diagnosis. In China, meningeal metastasis of breast cancer is a relatively rare type. Methods: The clinical characteristics, imaging data, cerebrospinal fluid cytology and treatment options of 6 patients with meningeal metastasis of breast cancer treated in our hospital were analyzed. Results: The median age of Neoplastic meningitis was 50 years old. The cerebrospinal fluid pressure of the 6 patients increased to varying degrees and tumor cells were found in the cerebrospinal fluid. Of the 6 patients, 2 received only supportive care, and the rest received chemotherapy and intrathecal injection. The shortest survival time was 1 week, and the longest survival time was over 33.2 weeks. Conclusions: Patients whose initial Karnofsky Performance Scale scores were good and who received active and regular treatment after the diagnosis of NM had long overall survival time.

show abstract

“…Although nearly every advanced solid tumor has been reported to metastasize to leptomeninges, LM is frequently detected in lung cancer, breast cancer, and melanoma [3] [6]. However, in studies on LM from Asian countries, cases arising from melanoma were rare, and gastric cancer was one of the most principal etiologies of LM [7][8] [9]. However, LM is not a common complication of gastric cancer, the prevalence of LM was reported 0.17-0.43% [10] [19].…”

Section: Discussionmentioning

confidence: 99%

“…[9][25]. Most patients have extensive systemic tumor burden at time of LM diagnosis, and systemic chemotherapy could be effective for treatment of systemic disease.Several studies reported that PS was one of the most important prognostic factors in patients with LM [7][8][16][25].…”

mentioning

confidence: 99%

The clinical outcomes of leptomeningeal metastasis and intrathecal MTX in patients with gastric cancer: A retrospective analysis

Lee

2018

JPT

View full text Add to dashboard Cite

Aim: The aim of this study was to report the clinical features of patients with LM originating from gastric cancer and the outcomes of intrathecal (IT) chemotherapy with methotrexate (MTX) in these patients. Method: This study analyzed retrospectively the medical records of 10 patients with gastric cancer, who were diagnosed with LM and received IT chemotherapy with MTX at Kosin University Gospel Hospital between January 2007 and December 2017. Results: Of 10 patients, half was male and the median age at LM diagnosis was 49 years (rang, 33–72). All patients but one had a poor performance status. Seven patients had poorly differentiated or signet ring cell adenocarcinomas, and six had Borrmann type III or IV gastric cancer. The median time from diagnosis of gastric cancer to the development of LM was 22.6 months (range, 4.93–103.7). LM was detected by brain magnetic resonance imaging in 6 patients, and was established in cerebrospinal fluid (CSF) analysis in all 10 patients. IT MTX for LM was administrated in all 10 patients, and the median 6 cycles of IT MTX was performed (range, 1–35). Three patients achieved negative conversion of malignant cytology in CSF. Systemic chemotherapy was performed in 5 patients. The median survival time from LM diagnosis was 2.1 months (95% confidence interval [CI], 1.5–2.7). Two patients survived about 12 months after LM diagnosis. Conclusion: Although the prognosis of LM in gastric cancer patients was poor, the administration of IT MTX might have clinical benefit in some selected patients.

show abstract

Impact of Multimodality Approach for Patients with Leptomeningeal Metastases from Solid Tumors

Cited by 23 publications

References 26 publications

A Retrospective Analysis of the Clinical Outcomes of Leptomeningeal Metastasis in Patients with Solid Tumors

A Retrospective Analysis of the Clinical Outcomes of Leptomeningeal Metastasis in Patients with Solid Tumors

6 Cases of Breast Cancer-Associated Neoplastic Meningitis and Literature Review

The clinical outcomes of leptomeningeal metastasis and intrathecal MTX in patients with gastric cancer: A retrospective analysis

Contact Info

Product

Resources

About