OBJECTIVE: To compare the efficacy of intrathecal methotrexate single therapy with three-drug combination therapy in patients with leptomeningeal carcinomatosis. METHODS: Fifty-five patients who had pathologically proven leptomeningeal carcinomatosis of a solid tumor were evaluated in terms of pathological response. Group M (n = 29) received methotrexate 15 mg and group MHA (n = 26) received methotrexate 15 mg, hydrocortisone 15 mg/m(2) and ara-C 30 mg/m(2) twice a week intrathecally until a cytological response was obtained. RESULTS: Primary sites of the tumor were the lung (n = 33), breast (n = 13) and stomach (n = 5). The pathology of 45 patients was adenocarcinoma. The cytological response rate to intrathecal chemotherapy was significantly higher in the MHA group than in the M group (38.5 vs 13.8%, P = 0.036). The median survival was 18.6 weeks in the MHA arm and 10.4 weeks in the M arm (P = 0.029). CONCLUSION: Combination intrathecal chemotherapy with methotrexate, cytosine arabinoside and hydrocortisone showed more favorable effects than methotrexate single therapy for leptomeningeal carcinomatosis in solid tumors.
OBJECTIVE: To compare the efficacy of intrathecal methotrexate single therapy with three-drug combination therapy in patients with leptomeningeal carcinomatosis. METHODS: Fifty-five patients who had pathologically proven leptomeningeal carcinomatosis of a solid tumor were evaluated in terms of pathological response. Group M (n = 29) received methotrexate 15 mg and group MHA (n = 26) received methotrexate 15 mg, hydrocortisone 15 mg/m(2) and ara-C 30 mg/m(2) twice a week intrathecally until a cytological response was obtained. RESULTS: Primary sites of the tumor were the lung (n = 33), breast (n = 13) and stomach (n = 5). The pathology of 45 patients was adenocarcinoma. The cytological response rate to intrathecal chemotherapy was significantly higher in the MHA group than in the M group (38.5 vs 13.8%, P = 0.036). The median survival was 18.6 weeks in the MHA arm and 10.4 weeks in the M arm (P = 0.029). CONCLUSION: Combination intrathecal chemotherapy with methotrexate, cytosine arabinoside and hydrocortisone showed more favorable effects than methotrexate single therapy for leptomeningeal carcinomatosis in solid tumors.
Authors: Karin Oechsle; Victoria Lange-Brock; Andreas Kruell; Carsten Bokemeyer; Maike de Wit Journal: J Cancer Res Clin Oncol Date: 2010-03-04 Impact factor: 4.553
Authors: Brian J Scott; Vincent A van Vugt; Toni Rush; Tiffany Brown; Clark C Chen; Bob S Carter; Richard Schwab; Paul Fanta; Teresa Helsten; Lyudmila Bazhenova; Barbara Parker; Sandeep Pingle; Marlon G Saria; Bradley D Brown; David E Piccioni; Santosh Kesari Journal: J Neurooncol Date: 2014-06-19 Impact factor: 4.130