Background: Leptomeningeal carcinomatosis (LC) represents a devastating complication of systemic cancer, and patients with LC have a dismal prognosis and increased mortality. The few studies that have focused on the evaluation of prognostic factors in patients with LC have resulted in contradictory results. Thus, the treatment of LC remains controversial, and no straightforward guidelines exist in the literature. The objective of the current study was to identify prognostic markers related to LC survival to better select patients who are eligible for intensive treatment.
Methods: Seventy patients who had a diagnosis of LC were reviewed, and clinical data, cerebrospinal fluid (CSF) parameters, tumor-related characteristics, and treatment information were registered. The impact of single parameters on overall survival was determined by both univariate and multivariate analyses.
Results: The multivariate analysis revealed that Radiation Therapy Oncology Group score
Conclusions: The predictive factors for patients with LC that were identified in this study could help to better select patients who are more likely to benefit from chemotherapy.
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http://dx.doi.org/10.1002/cncr.24041 | DOI Listing |
Radiol Case Rep
March 2025
Maimonides Medical Center, Department of Radiology 4802 10th Avenue, Brooklyn, NY 11219, USA.
Leptomeningeal carcinomatosis is a form of advanced metastatic disease conferring poor prognosis, most commonly associated with melanoma, small cell lung cancer, and breast cancer. In rare cases it has been shown to be associated with stroke thought to be related to vasculopathy caused by tumoral infiltration of cerebral vasculature. We present a case of acute cerebellar infarction in a patient with metastatic breast cancer complicated by leptomeningeal carcinomatosis, admitted for worsening metastatic disease.
View Article and Find Full Text PDFCurr Med Imaging
January 2025
Department of Radiology, Sengkang General Hospital, Singapore.
Background: Leptomeningeal enhancement, visible on MRI, can indicate a variety of diseases, both neoplastic and non-neoplastic.
Objective: This comprehensive pictorial review aims to equip radiologists and trainees with a thorough understanding of the diverse imaging presentations of leptomeningeal disease.
Methods: Drawing from a retrospective analysis of MRI scans conducted between 1 January 2008 and 30 September 2022, at two tertiary teaching hospitals in Singapore, this review covers a wide range of conditions.
Cancer Chemother Pharmacol
December 2024
Division of Oncology, Department of Medicine, Stanford University School of Medicine, Stanford Cancer Institute, Stanford, USA.
Progressive leptomeningeal metastases (LM) are associated with intractable neurological symptoms and a poor prognosis, and effective treatment options are limited. Intrathecal (IT) pemetrexed has been shown to confer clinical benefit in lung adenocarcinoma, yet our understanding of the efficacy and safety of the treatment is limited. We report a patient with a long-standing history of leptomeningeal disease due to ALK-positive adenocarcinoma of the lung, previously controlled by increased doses of lorlatinib (125 mg/day).
View Article and Find Full Text PDFFront Oncol
November 2024
Department of Medicine, Medical Oncology Division, British Columbia (BC) Cancer, Vancouver Centre, University of British Columbia, Vancouver, BC, Canada.
JCO Precis Oncol
December 2024
Department of Medical Oncology and Therapeutics Research, City of Hope, Duarte, CA.
Purpose: Leptomeningeal disease (LMD) is associated with significant morbidity and mortality for metastatic non-small cell lung cancer (NSCLC). We describe our clinical experience in evaluating the use of cerebrospinal fluid (CSF)-derived circulating tumor cells (CTCs) for the diagnosis of LMD and the detection of genomic alterations in CSF cell-free DNA (cfDNA).
Methods: Patients with NSCLC who had CSF collection as part of routine clinical care for suspected LMD were included in the study.
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