Outcomes and clinical features of leptomeningeal carcinomatosis: A single center experience

Yıl 2019, Cilt: 32 Sayı: 2, 81 - 85, 31.05.2019

Derya Kıvrak Salım , Arif Hakan Onder

https://doi.org/10.5472/marumj.570913

Öz

Objective: The aim of this study was to identify the clinical features
and prognostic factors of cancer patients with leptomeningeal
carcinomatosis (LMC) in a single center.
Patients and Methods: Patients 18 and older who had
LMC diagnosis between 2013 and 2018 at Medical Oncology
Department, Antalya Education and Research Hospital, Health
Sciences University were included into the study. Their clinical
features, treatment approaches, overall survival, survival after LMC
diagnosis and prognostic factors on survival were retrospectively
investigated.
Results: Sixteen solid cancer patients included in the study.
The median time from primary tumor diagnosis to LMC diagnosis
was 6 months (range, 1-180 months). The median time from LMC
diagnosis to death was 1.5 months (range, 1-14 months). The
median overall survival for the entire population was 11 months
(95%CI 5.7-16.3). Age (p=0.6), gender (p=0.51), metastases areas
(for liver metastases p=0.95, for lung metastases p=0.26, for bone
metastases p=0.82), The Eastern Cooperative Oncology Group
Performance Status ( ECOG PS) (p=0.18), treatment type of LMC
(only radiation therapy (RT) p=0.33; RT followed by intrathecal
methotrexate (IT MTX) (p=0.35), RT type (p=0.76) and time from
primary tumor diagnosis to LMC diagnosis (p=0.50) did not show
prognostic effect on overall survival after LMC diagnosis.
Conclusion: Overall survival after LMC diagnosis is too short
to see the effect of treatment modalities. Our study did not find any
favorable or unfavorable prognostic factor on survival after LMC
diagnosis.

Anahtar Kelimeler

Leptomeningeal carcinomatosis, Survival, Prognostic factors

Kaynakça

• 1. Lee SJ, Lee JI, Nam DH, et al. Leptomeningeal carcinomatosis in non-small-cell lung cancer patients: impact on survival and correlated prognostic factors. J Thorac Oncol 2013; 8:185-91. doi: 10.1097/JTO.0b013e3182773f21.
• 2. Giglio P, Weinberg JS, Forman AD, Wolff R, Groves MD. Neoplastic meningitis in patients with adenocarcinoma of the gastrointestinal tract. Cancer 2005;103: 2355-62.
• 3. Kak M, Nanda R, Ramsdale EE, Lukas RV. Treatment of leptomeningeal carcinomatosis: current challenges and future opportunities. J Clin Neurosci 2015; 22:632-7. doi: 10.1016/j.jocn.2014.10.022.
• 4. Hyun JW, Jeong IH, Joung A, Cho HJ, Kim SH, Kim HJ. Leptomeningeal metastasis: Clinical experience of 519 cases. Eur J Cancer 2016; 56:107-4. doi: 10.1016/j.ejca.2015.12.021
• 5. Smalley KS, Fedorenko IV, Kenchappa RS, Sahebjam S, Forsyth PA. Managing leptomeningeal melanoma metastases in the era of immune and targeted therapy. Int J Cancer 2016; 139:1195-201.
• 6. Gwak HS, Joo J, Kim S, et al. Analysis of treatment outcomes of intraventricular chemotherapy in 105 patients for leptomeningeal carcinomatosis from non-small-cell lung cancer. J Thorac Oncol 2013; 8: 599-605. doi: 10.1002/ ijc.30147.
• 7. Palma JA, Fernandez-Torron R, Esteve-Belloch P, et al. Leptomeningeal carcinomatosis: prognostic value of clinical, cerebrospinal fluid, and neuroimaging features. Clin Neurol Neurosurg 2013; 115:19-25.
• 8. Segura PP, Gil M, Balañá C, et al. Phase II trial of temozolomide for leptomeningeal metastases in patients with solid tumors. J Neurooncol 2012;109:137-42. doi:10.1016/j. clineuro.2012.03.048.
• 9. Herrlinger U, Forschler H, Kuker W, et al. Leptomeningealmetastasis: survival and prognostic factors in 155 patients. JNeurol Sci 2004; 223:167e78.
• 10. Bruna J, González L, Miró J, Velasco R, Gil M, Tortosa A. Leptomeningeal carcinomatosis:prognostic implications of clinical and cerebrospinal fluid features. Cancer 2009; 115:381-9. doi: 10.1002/cncr.24041.
• 11. Waki F, Ando M, Takashima A, et al. Prognostic factors and clinical outcomes in patients with leptomeningeal metastasis from solid tumors. J Neurooncol 2009; 93:205-12. doi: 10.1007/s11060.008.9758-3.
• 12. Clarke JL, Perez HR, Jacks LM, Panageas KS, Deangelis LM. Leptomeningeal metastases in the MRI era. Neurology 2010;74:1449-54. doi:10.1212/WNL.0b013e3181dc1a69.
• 13. Du C, Hong R, Shi Y, Yu X, Wang J. Leptomeningeal metastasis from solid tumors: a single center experience in Chinese patients. J Neurooncol 2013; 115: 285-91.doi: 10.1007/s11060.013.1228-x.
• 14. Passarin MG, Sava T, Furlanetto J, et al. Leptomeningeal metastasis from solid tumors: a diagnostic Leptomeningeal metastasis from solid tumors: a diagnostic and therapeutic challenge. Neurol Sci 2015; 36:117-23. doi: 10.1007/ s10072.014.1881-7.
• 15. Boogerd W, van den Bent MJ, Koehler PJ, et al. The relevance of intraventricular chemotherapy for leptomeningeal metastasis in breast cancer: a randomised study. Eur J Cancer 2004;40:2726-33.
• 16. El Shafie RA, Böhm K, Weber D, et al. Outcome and prognostic factors following palliative craniospinal irradiation for leptomeningeal carcinomatosis. Cancer Manag Res 2019;11:789-801. doi: 10.2147/CMAR.S182154.
• 17. El Shafie RA, Böhm K, Weber D, et al. Palliative radiotherapy for leptomeningeal carcinomatosis-analysis of outcome, prognostic factors, and symptom response. Front Oncol 2019;8:641. doi: 10.3389/fonc.2018.00641.
• 18. Freilich RJ, Krol G, DeAngelis LM. Neuroimaging and cerebrospinal fluid cytology in the diagnosis of leptomeningeal metastasis. Ann Neurol 1995;38:51-7.