Therapy of leptomeningeal metastasis in solid tumors

Mack, Frederic; Baumert, Brigitta G.; Schäfer, N.; Hattingen, Elke; Scheffler, Björn; Herrlinger, Ulrich; Glas, Martin

doi:10.1016/j.ctrv.2015.12.004

Cited by 133 publications

(116 citation statements)

References 89 publications

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“…Survival periods after radiation therapy of the brain is still with a medium of 2 months. We could not establish clear foci of intracranial metastasis or meningeal occlusion sites throughout the whole CNS [1].…”

Section: Discussionmentioning

confidence: 64%

“…Brain images showed hydrocephalus which could have been managed through a ventriculo-peritoneal shunt, a procedure which was considered by our neurology team but felt to be of minimal benefit, unlikely to result in the patient's awakening and offer no meaningful treatment response [1].…”

Section: Discussionmentioning

confidence: 99%

“…Frequent symptoms of Leptomeningeal carcinomatosis are cranial nerve paralyses, non-specific headaches, back pain, hearing loss and neurocognitive syndromes [1].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

A Silent and Debilitating Case of Obstructing Hydrocephalus

Zaharcu¹,

Kumar²,

Baker³

et al. 2017

Oncology and cancer case reports

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Section: Discussionmentioning

confidence: 64%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A Silent and Debilitating Case of Obstructing Hydrocephalus

Zaharcu¹,

Kumar²,

Baker³

et al. 2017

Oncology and cancer case reports

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“…[1][2][3] Although there is rarely a solid tumor that exists in leptomeningeal carcinomatosis to resect, there is a role for neurosurgical intervention.…”

Section: Introductionmentioning

confidence: 99%

Surgical Treatment for Leptomeningeal Disease

2017

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Background Advancements in cancer treatment have led to more cases of leptomeningeal disease, which requires a multimodal approach. Methods Treatment modalities are reviewed from a neurosurgical standpoint, focusing on intrathecal chemotherapy and shunting devices. Potential complications and how to avoid them are discussed. Results The Ommaya reservoir and the chemoport are used for administering intrathecal chemotherapy. Use of ventriculo-lumbar perfusion can efficiently deliver chemotherapeutic agents and improve intracerebral pressure. Shunting systems, in conjunction with all of their variations, address the challenge of hydrocephalus in leptomeningeal carcinomatosis. Misplaced catheters, malfunction of the system, and shunt-related infections are known complications of treatment. Conclusions From an oncological perspective, the surgical treatment for leptomeningeal disease is limited; however, neurosurgery can be used to aid in the administration of chemotherapy and address the issue of hydrocephalus. Minimizing surgical complications is important in this sensitive patient population.

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“…Leptomeningeal metastasis (LM) is defined by tumor cell spread to the leptomeninges and subarachnoid space [1]. Breast cancer, lung cancer, and melanoma are the most frequent causes of LM…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Liposomal Cytarabine in the Treatment of Leptomeningeal Metastasis of Breast Cancer

2017

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Background: Breast cancer is one of the most frequent causes of leptomeningeal metastasis (LM) among solid tumors in adults. The prognosis of patients with LM is poor. A treatment option is the intrathecal administration of liposomal cytarabine. Case Reports: The first case represents a 53-year-old woman with LM of breast cancer. A neurological response was achieved shortly after the start of the multimodal treatment including intrathecal liposomal cytarabine. The response duration reached 79 days. The second case represents a 48-year-old woman with LM of breast cancer treated with intrathecal liposomal cytarabine as a part of a multimodal treatment approach. A neurological response was achieved in the first 2 weeks of treatment and is still lasting after 18 months. Conclusion: These cases suggest that a rapid response to a prompt start of treatment with intrathecal liposomal cytarabine in patients with LM of breast cancer is feasible. In 1 case an extremely long progression-free survival (18+ months) was achieved. The cases support the efficacy of liposomal cytarabine in the management of LM in breast cancer patients as a part of a multimodal treatment approach and underline the need for further investigations in this specific cohort.

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Therapy of leptomeningeal metastasis in solid tumors

Cited by 133 publications

References 89 publications

A Silent and Debilitating Case of Obstructing Hydrocephalus

A Silent and Debilitating Case of Obstructing Hydrocephalus

Surgical Treatment for Leptomeningeal Disease

Efficacy of Liposomal Cytarabine in the Treatment of Leptomeningeal Metastasis of Breast Cancer

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