Clinical features and prognostic factors in patients with leptomeningeal metastases.
- Author:
Ning LI
1
;
Bo-yan YANG
2
;
Jun-ling LI
;
Ji-qing ZHU
;
Bao-hua ZOU
;
Yan-feng WANG
;
Lei YU
;
Xiao-ying YAO
Author Information
- Publication Type:Journal Article
- MeSH: Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; therapeutic use; Breast Neoplasms; pathology; Combined Modality Therapy; Female; Follow-Up Studies; Humans; Lung Neoplasms; pathology; Male; Meningeal Carcinomatosis; drug therapy; radiotherapy; secondary; Middle Aged; Multivariate Analysis; Particle Accelerators; Prognosis; Retrospective Studies; Stomach Neoplasms; pathology; Survival Rate; Young Adult
- From: Chinese Journal of Oncology 2013;35(11):867-870
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVETo investigate the clinical characteristics and prognostic factors of leptomeningeal metastases (LM) from solid tumors and to develop better treatment strategies.
METHODSThe clinical characteristics and follow-up results of 77 cases of leptomeningeal metastases (LM) from solid tumors diagnosed and treated in our hospital from 2002 to 2011 were retrospectively analyzed. Clinical characteristics, treatment methods and overall survival were analyzed using Kaplan-Meier method and Cox regression model.
RESULTSThe median survival time for all the patients was 88 days. KPS score, control of the primary tumor and systemic treatment were correlated with survival time for the patients (P < 0.05 for all). The median survival time of systemic treatment was 150 d and those without systemic treatment (chemotherapy and/or targeted therapy) after LM was 60 d (P = 0.001). Systemic therapy combined with local treatment (radiotherapy to the meninges or intrathecal chemotherapy) further improved the survival time of patients. Multivariate analysis showed that KPS and short-term therapeutic response for the LM were independent prognostic factors (P < 0.05 for both).
CONCLUSIONSKPS and short-term therapeutic response are independent prognostic factores for leptomeningeal metastases from solid tumors. Systemic chemotherapy or targeted therapy can prolong the survival time. Systemic treatment (chemotherapy and/or targeted therapy) combined with radiation therapy or intrathecal injection may further improve the clinical outcomes.