Leptomeningeal Carcinomatosis

Abstract

We conclude that female sex, longer duration of neurological symptoms, absence of cerebral leptomeningeal clinical involvement, and absence of elevated CSF protein independently predict better survival. Patients treated with intra-CSF chemotherapy also survived longer.

Carcinoma Meningitis Secondary to Non–Small Cell Lung Cancer

“…Wasserstrom et al reported a 50% response rate and a median survival of 4 months in patients with both small cell and non-small cell lung primaries. These findings are similar to those of 2 other large studies 25,26 of carcinomatous meningitis in which 25 and 10 patients with non-small cell lung cancer and LM were reported, respectively; however, median survival in both of these studies (1.5 and 2.5 months, respectively) was considerably shorter. These data, and ours, suggest that patients with non-small cell lung cancer complicated by LM can be palliated with aggressive multimodal therapy; however, determining which patients are candidates for aggressive therapy is problematic.…”

Carcinoma Meningitis Secondary to Non–Small Cell Lung Cancer

“…Wasserstrom et al reported a 50% response rate and a median survival of 4 months in patients with both small cell and non-small cell lung primaries. These findings are similar to those of 2 other large studies 25,26 of carcinomatous meningitis in which 25 and 10 patients with non-small cell lung cancer and LM were reported, respectively; however, median survival in both of these studies (1.5 and 2.5 months, respectively) was considerably shorter. These data, and ours, suggest that patients with non-small cell lung cancer complicated by LM can be palliated with aggressive multimodal therapy; however, determining which patients are candidates for aggressive therapy is problematic.…”

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

“…As most studies were conducted retrospectively, performance status was estimated by researcher based on medical records in contrast to other variables, such as CSF or image findings and therefore is subject to bias. Boogerd et al (15) reported that age older than 55 yr is one of negative prognostic factors, but study by Balm et al (18) and current study showed that age is not a predictive factor. According to manifesting symptoms, Boogerd et al (15) and Balm et al (18) demonstrated that patients with symptoms related to cranial nerve or cerebral involvement had worse prognosis, respectively.…”

“…Boogerd et al (15) reported that age older than 55 yr is one of negative prognostic factors, but study by Balm et al (18) and current study showed that age is not a predictive factor. According to manifesting symptoms, Boogerd et al (15) and Balm et al (18) demonstrated that patients with symptoms related to cranial nerve or cerebral involvement had worse prognosis, respectively. However the relationship between symptoms and outcomes was conflicted with each other studies (15, 16, 19).…”

A Case of Isolated CNS Relapse in a CML Patient on Chronic Phase

“…Headache and mental status changes are the most common cerebral symptoms. Facial weakness, facial numbness, diplopia, visual problems are manifestations of cranial nerve involvement [24]. In our patient, a chronic benign headache was the first manifestation which was attributed to other brain pathology, the clincher to the diagnosis of a possible leptomeningeal metastasis was the development of loss of vision from cranial nerve compression or involvement.…”

Carcinoma Meningitis Secondary to Non–Small Cell Lung Cancer

“…Wasserstrom et al reported a 50% response rate and a median survival of 4 months in patients with both small cell and non-small cell lung primaries. These findings are similar to those of 2 other large studies 25,26 of carcinomatous meningitis in which 25 and 10 patients with non-small cell lung cancer and LM were reported, respectively; however, median survival in both of these studies (1.5 and 2.5 months, respectively) was considerably shorter. These data, and ours, suggest that patients with non-small cell lung cancer complicated by LM can be palliated with aggressive multimodal therapy; however, determining which patients are candidates for aggressive therapy is problematic.…”

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

“…As most studies were conducted retrospectively, performance status was estimated by researcher based on medical records in contrast to other variables, such as CSF or image findings and therefore is subject to bias. Boogerd et al (15) reported that age older than 55 yr is one of negative prognostic factors, but study by Balm et al (18) and current study showed that age is not a predictive factor. According to manifesting symptoms, Boogerd et al (15) and Balm et al (18) demonstrated that patients with symptoms related to cranial nerve or cerebral involvement had worse prognosis, respectively.…”

“…Boogerd et al (15) reported that age older than 55 yr is one of negative prognostic factors, but study by Balm et al (18) and current study showed that age is not a predictive factor. According to manifesting symptoms, Boogerd et al (15) and Balm et al (18) demonstrated that patients with symptoms related to cranial nerve or cerebral involvement had worse prognosis, respectively. However the relationship between symptoms and outcomes was conflicted with each other studies (15, 16, 19).…”

A Case of Isolated CNS Relapse in a CML Patient on Chronic Phase

“…Headache and mental status changes are the most common cerebral symptoms. Facial weakness, facial numbness, diplopia, visual problems are manifestations of cranial nerve involvement [24]. In our patient, a chronic benign headache was the first manifestation which was attributed to other brain pathology, the clincher to the diagnosis of a possible leptomeningeal metastasis was the development of loss of vision from cranial nerve compression or involvement.…”

Carcinoma Meningitis Secondary to Non–Small Cell Lung Cancer

“…Wasserstrom et al reported a 50% response rate and a median survival of 4 months in patients with both small cell and non-small cell lung primaries. These findings are similar to those of 2 other large studies 25,26 of carcinomatous meningitis in which 25 and 10 patients with non-small cell lung cancer and LM were reported, respectively; however, median survival in both of these studies (1.5 and 2.5 months, respectively) was considerably shorter. These data, and ours, suggest that patients with non-small cell lung cancer complicated by LM can be palliated with aggressive multimodal therapy; however, determining which patients are candidates for aggressive therapy is problematic.…”

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

“…As most studies were conducted retrospectively, performance status was estimated by researcher based on medical records in contrast to other variables, such as CSF or image findings and therefore is subject to bias. Boogerd et al (15) reported that age older than 55 yr is one of negative prognostic factors, but study by Balm et al (18) and current study showed that age is not a predictive factor. According to manifesting symptoms, Boogerd et al (15) and Balm et al (18) demonstrated that patients with symptoms related to cranial nerve or cerebral involvement had worse prognosis, respectively.…”

“…Boogerd et al (15) reported that age older than 55 yr is one of negative prognostic factors, but study by Balm et al (18) and current study showed that age is not a predictive factor. According to manifesting symptoms, Boogerd et al (15) and Balm et al (18) demonstrated that patients with symptoms related to cranial nerve or cerebral involvement had worse prognosis, respectively. However the relationship between symptoms and outcomes was conflicted with each other studies (15, 16, 19).…”

A Case of Isolated CNS Relapse in a CML Patient on Chronic Phase

“…Headache and mental status changes are the most common cerebral symptoms. Facial weakness, facial numbness, diplopia, visual problems are manifestations of cranial nerve involvement [24]. In our patient, a chronic benign headache was the first manifestation which was attributed to other brain pathology, the clincher to the diagnosis of a possible leptomeningeal metastasis was the development of loss of vision from cranial nerve compression or involvement.…”