Craniospinal irradiation in the treatment of chemotherapy refractory leptomeningeal metastasis from breast cancer: A case report.

Background: Leptomeningeal carcinomatosis is a relatively uncommon complication of solid tumors that is associated with significant morbidity and mortality. Prognosis is typically weeks to months and the neurologic complications of this disease can significantly affect quality of life. The role of craniospinal irradiation is unclear as evidence exploring this treatment option is limited. Despite lack of evidence, its use has decreased due to its associated acute toxicities and newer intrathecal alternatives.

Case: Here we report the case of a 50-year-old patient who received craniospinal irradiation for chemotherapy-refractory leptomeningeal disease, with survival well beyond the median and good quality of life for the majority of that time.

Conclusion: This patient's remarkable survival and performance after treatment suggests that craniospinal irradiation could be considered more frequently in the treatment of leptomeningeal metastases. To our knowledge, this is the first case with significant survival following craniospinal irradiation for chemotherapy refractory disease presented. Further study on the use of craniospinal irradiation to treat leptomeningeal metastasis is recommended.