Outcome after whole brain radiotherapy alone in intracranial leptomeningeal carcinomatosis from solid tumors

Gani, Cihan; Müller, Arndt-Christian; Eckert, Franziska; Schroeder, Christopher; Bender, Benjamín; Pantazis, Georgios; Bamberg, M.; Berger, Bernhard

doi:10.1007/s00066-011-0025-8

Cited by 62 publications

(35 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Likewise, in our study, we demonstrated that the patients with ECOG 1 had the best OS (5.7 months) compared to patients with ECOG 2 (3.7 months; p < 0.01) or 3 (2.9 months; p < 0.001). Lending support to our findings, Gani et al and Waki et al also reported a survival difference in favor of patients with better ECOG PS after various treatments including WBRT [23,24]. Therefore, in spite of the fact that the methods used might confound the comparison between the two studies, the results of a relatively larger study of 149 LMC patients indicated that other than the use of WBRT, good ECOG PS was the main factor associated with longer OS [17].…”

Section: Fig 2 Overall Survival In 51 Patientssupporting

confidence: 81%

“…Despite the fact that the prognostic value of the TT-LMC was analyzed by various investigators [17,23], to our knowledge, the present study was the first to assign a significant prognostic value to this variable in pure NSCLC patients treated exclusively with WBRT. Compared to 11.3 months, Palma et al [21] reported that patients with TT-LMC > 67 weeks (15.6 months) had significantly longer OS.…”

Section: Fig 2 Overall Survival In 51 Patientsmentioning

confidence: 73%

See 1 more Smart Citation

Whole brain radiotherapy in management of non-small-cell lung carcinoma associated leptomeningeal carcinomatosis: evaluation of prognostic factors

2016

View full text Add to dashboard Cite

To assess the efficacy of whole-brain radiotherapy (WBRT) and prognostic factors in leptomeningeal carcinomatosis (LMC) of non-small-cell lung cancer (NSCLC) patients. WBRT records of 51 LMC patients confined to brain were reviewed. Eligible patients had squamous-cell carcinoma (SCC) or adenocarcinoma, and Eastern Cooperative Oncology Group Performance Status (ECOG PS) 0-3. The WBRT was either 20 or 30 Gray. The primary and secondary objectives were to determine overall survival (OS) and prognostic factors for improved treatment response, respectively. Median age was 53 years (range 39-68), 58.8 % had SCC, 74.5 % had ECOG PS 1-2, and 70.6 % had LMC accompanied by parenchymal brain metastases (BM). The median follow-up was 4.1 months (range 0.7-14.4); all patients died due to disease progression. Median OS was 3.9 months (95 % CI 3.3-4.5) with 6 and 12 month estimates of 19.6 and 5.9 %, respectively. Evaluation of prognostic factors revealed that patients with ECOG 1, longer time to LMC (TT-LMC) from NSCLC diagnosis (>11.3 months), and absence of parenchymal BM had significantly superior OS than those patients with ECOG 2 (p = 0.01) or 3 (p < 0.001), TT-LMC < 11.3 months (p = 0.001), and parenchymal BM (p = 0.012). Median OS of 3.9 months after WBRT appeared to confirm the poor prognosis of LMC. WBRT might be most effective for patients with favorable PS, longer TT-LMC, and no accompanying BM. Therefore, we identified ECOG PS 1, TT-LMC > 11.3 months, and no BM as independent prognosticators for better response to WBRT in NSCLC patients with LMC.

show abstract

Section: Fig 2 Overall Survival In 51 Patientssupporting

confidence: 81%

Section: Fig 2 Overall Survival In 51 Patientsmentioning

confidence: 73%

Whole brain radiotherapy in management of non-small-cell lung carcinoma associated leptomeningeal carcinomatosis: evaluation of prognostic factors

2016

View full text Add to dashboard Cite

show abstract

“…However, the very short survival time of many patients with LM even after WBRT challenges its generalized use: a recent study of 125 patients with LM from non-small cell lung cancer demonstrated no benefit of WBRT between patients treated with or without WBRT concerning survival [36]. Similar results are reported in another retrospective study for patients with LM from breast or lung cancer treated by WBRT with a median overall survival of 2 months [47].…”

Section: Radiotherapymentioning

confidence: 61%

“…Interestingly the absence of cranial nerve dysfunction was significantly associated with a better survival. On the other hand, symptom control in patients with dysfunction of central cranial nerves due to larger leptomeningeal metastasis could be another indication for WBRT, although there is likely no benefit on survival especially in those patients [47]. In this context it is important to note that these and other cohort studies did not include quality-of-life measures that address the patients' benefit e.g.…”

Section: Radiotherapymentioning

confidence: 97%

Therapy of leptomeningeal metastasis in solid tumors

Mack

Baumert

Schäfer

et al. 2016

Cancer Treatment Reviews

132

View full text Add to dashboard Cite

“…Previous studies indicated that intrathecal chemotherapy does not improve OS times in solid tumors (18)(19)(20) and National Comprehensive Cancer Network (NCCN) guidelines suggest that radiation therapy alone may produce a positive effect with less toxicity. However, studies have demonstrated that radiation therapy alone only alleviated symptoms of the nervous system and did not prolong patient OS times (21,22).…”

Section: Discussionmentioning

confidence: 99%

Leptomeningeal metastasis of pulmonary large-cell neuroendocrine carcinoma: A case report and review of the literature

Yang

Pan

et al. 2017

Oncology Letters

View full text Add to dashboard Cite

Abstract. Pulmonary large-cell neuroendocrine carcinoma (LCNEC) is a rare and malignant form of lung cancer with a poor prognosis for patients. The common sites of metastases are the liver, adrenal glands, bone and brain. LCNEC rarely metastasizes to the small intestine, ovaries, tonsils, mandible, vulva or spine. To the best of our knowledge, there have been no reports of leptomeningeal metastasis of LCNEC to date. The present case report describes an unusual case of leptomeningeal metastasis from pulmonary LCNEC alongside a review of the literature. Biopsies of pulmonary lesions and cervical lymph nodes confirmed the diagnosis of LCNEC in a 39-year-old male patient. At 2 months after chemotherapy, the patient began to experience hoarseness, epileptic seizures and blurred vision. Furthermore, the patient presented with radiating pain and numbness in his lower left limb. Imaging findings and cytological examination of cerebral spinal fluid supported the diagnosis of leptomeningeal metastasis. The patient's neurological symptoms were markedly alleviated following receipt of radiation and intrathecal chemotherapy. The patient survived for 4.9 months after diagnosis with leptomeningeal metastasis. To the best of our knowledge, the present case report is the first to describe leptomeningeal metastasis from pulmonary LCNEC confirmed by neuroimaging and cerebral spinal fluid cytology. It suggests that leptomeningeal metastasis does occur in this rare disease, and aggressive treatment may result in improved symptoms and possibly survival times. IntroductionPulmonary large-cell neuroendocrine carcinoma (LCNEC) is a rare type of lung cancer that accounts for <1% of all primary lung malignancies (1). Since the biological behavior of LCNEC is similar to that of small cell lung cancer (SCLC), patients with LCNEC are often misdiagnosed and have an extremely poor prognosis (2). The 5-year survival rates for patients with LCNEC have been revealed to be significantly decreased compared with patients with other histological types of non-small cell lung cancer (NSCLC) (2,3).The common sites of metastasis from LCNEC are the liver, adrenal glands, bone, and brain, with hematogenous metastasis being the primary cause of treatment failure. Until recently, the rare sites of metastases from LCNEC which have been reported include the ovaries, small intestine, mandible, tonsil, vulva and prostate (4-9). In addition, Tsimpas et al (10) reported a case of LCNEC metastasis in the cauda equina; however, the patient in this study did not receive a cerebrospinal fluid (CSF) test and was not able to be diagnosed with leptomeningeal metastasis. Paydas et al (11) reported a case of leptomeningeal metastasis from LCNEC, but no cytological examination had been performed and no line-enhancement imaging for the diagnosis of leptomeningeal metastasis was performed for the patient. To the best of our knowledge, the present case report is the first to describe leptomeningeal metastasis from pulmonary LCNEC confirmed by neuroimaging and CSF cytology. Thu...

show abstract

Outcome after whole brain radiotherapy alone in intracranial leptomeningeal carcinomatosis from solid tumors

Abstract: WBRT alone is an effective palliative treatment for patients unfit/unsuitable for chemotherapy and low performance status suffering from intracranial LMC. However, prognostic factors should be considered in order to identify patients who are likely to benefit from WBRT.

Cited by 62 publications

References 23 publications

Whole brain radiotherapy in management of non-small-cell lung carcinoma associated leptomeningeal carcinomatosis: evaluation of prognostic factors

Whole brain radiotherapy in management of non-small-cell lung carcinoma associated leptomeningeal carcinomatosis: evaluation of prognostic factors

Therapy of leptomeningeal metastasis in solid tumors

Leptomeningeal metastasis of pulmonary large-cell neuroendocrine carcinoma: A case report and review of the literature

Contact Info

Product

Resources

About