Impact of Multimodality Approach for Patients with Leptomeningeal Metastases from Solid Tumors.
10.3346/jkms.2014.29.8.1094
- Author:
Jeanny KWON
1
;
Eui Kyu CHIE
;
Kyubo KIM
;
Hak Jae KIM
;
Hong Gyun WU
;
Il Han KIM
;
Do Youn OH
;
Se Hoon LEE
;
Dong Wan KIM
;
Seock Ah IM
;
Tae You KIM
;
Dae Seog HEO
;
Yung Jue BANG
;
Sung W HA
Author Information
1. Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea. ekchie93@snu.ac.kr
- Publication Type:Original Article
- Keywords:
Leptomeningeal Metastases;
Prognostic Factor;
Solid Tumor
- MeSH:
Adult;
Aged;
Chemoradiotherapy/methods/*mortality/*statistics & numerical data;
Disease-Free Survival;
Female;
Humans;
Male;
Meningeal Neoplasms/mortality/*secondary/*therapy;
Middle Aged;
Neoplasm Recurrence, Local/*mortality/*prevention & control;
Prevalence;
Republic of Korea/epidemiology;
Retrospective Studies;
Risk Factors;
Survival Rate;
Treatment Outcome
- From:Journal of Korean Medical Science
2014;29(8):1094-1101
- CountryRepublic of Korea
- Language:English
-
Abstract:
The purpose of this study was to evaluate treatment patterns, outcome and prognosticators for patients with leptomeningeal metastases from solid tumor. Medical records of 80 patients from January 1, 2004 to May 31, 2011 were retrospectively reviewed. Most frequent site of origin was the lung (59%) followed by the breast (25%). Most patients were treated with intrathecal chemotherapy (90%) and/or whole brain radiotherapy (67.5%). Systemic therapy was offered to 27 patients (33.8%). Percentage of patients treated with single, dual, and triple modality were 32.5%, 43.8%, and 23.8%, respectively. Median survival was 2.7 months and 1 yr survival rate was 11.3%. Multivariate analysis showed that negative cerebrospinal fluid cytology, fewer chemotherapy regimen prior to leptomeningeal metastases, whole brain radiotherapy, systemic therapy, and combined modality treatment (median survival; single 1.4 vs. dual 2.8 vs. triple 8.3 months, P<0.001) had statistical significance on survival. Subgroup analysis of non-small cell lung cancer (NSCLC) patients showed that targeted therapy had significant independent impact on survival (median survival; 10.5 vs. 3.0 months, P=0.008). Unlike previous reports, survival of patients with NSCLC primary was comparable to breast primary. Furthermore, combined modality treatment for all patients and additionally targeted therapy for NSCLC patients should be considered in the treatment of leptomeningeal metastases from solid tumor.
