Leptomeningeal carcinomatosis: prognostic implications of clinical and cerebrospinal fluid features.

Abstract:

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 scoreor=2.7 mmol/L (P=.001), the presence of infratentorial symptoms at onset (P=.026), and intrathecal treatment (P<.001) were associated independently with longer overall survival in patients with LC. In addition, the same clinical factors also predicted response to treatment in such patients. 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.

journal_name

Cancer

journal_title

Cancer

authors

Bruna J,González L,Miró J,Velasco R,Gil M,Tortosa A,Neuro-Oncology Unit of the Institute of Biomedical Investigation of Bellvitge.

doi

10.1002/cncr.24041

subject

Has Abstract

pub_date

2009-01-15 00:00:00

pages

381-9

issue

2

eissn

0008-543X

issn

1097-0142

journal_volume

115

pub_type

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