BACKGROUND: The purpose of the present study was to investigate outcome after whole brain radiotherapy (WBRT) alone as a palliative treatment without concomitant chemotherapy for intracranial leptomeningeal carcinomatosis (LMC). PATIENTS AND METHODS: Overall survival and treatment response were retrospectively analyzed in 27 consecutive patients with LMC from breast and lung cancer. All patients had evidence of intracranial manifestations of LMC. Seven potential prognostic factors were evaluated. RESULTS: Median overall survival (OS) for the entire group was 8.1 weeks. OS rates after 6 and 12 months were 26% and 15%, respectively. Improvement of neurological deficits was observed in 3 patients. In 3 of 4 patients with follow-up MRI studies, a decreased size of contrast-enhanced lesions was observed. Prognostic factors for improved OS on univariate analysis were absence of cranial nerve dysfunction, Karnofsky Performance Score (KPS) > 60%, and time interval > 35 months between the initial diagnosis of malignant disease and development of LMC. On multivariate analysis, absence of cranial nerve dysfunction remained the only significant prognosticator for OS (median 3.7 vs. 19.4 weeks, p < 0.001). CONCLUSION: WBRT alone is an effective palliative treatment for patients unfit/unsuitable for chemotherapy and low performance status suffering from intracranial LMC. However, prognostic factors should be considered in order to identify patients who are likely to benefit from WBRT.
BACKGROUND: The purpose of the present study was to investigate outcome after whole brain radiotherapy (WBRT) alone as a palliative treatment without concomitant chemotherapy for intracranial leptomeningeal carcinomatosis (LMC). PATIENTS AND METHODS: Overall survival and treatment response were retrospectively analyzed in 27 consecutive patients with LMC from breast and lung cancer. All patients had evidence of intracranial manifestations of LMC. Seven potential prognostic factors were evaluated. RESULTS: Median overall survival (OS) for the entire group was 8.1 weeks. OS rates after 6 and 12 months were 26% and 15%, respectively. Improvement of neurological deficits was observed in 3 patients. In 3 of 4 patients with follow-up MRI studies, a decreased size of contrast-enhanced lesions was observed. Prognostic factors for improved OS on univariate analysis were absence of cranial nerve dysfunction, Karnofsky Performance Score (KPS) > 60%, and time interval > 35 months between the initial diagnosis of malignant disease and development of LMC. On multivariate analysis, absence of cranial nerve dysfunction remained the only significant prognosticator for OS (median 3.7 vs. 19.4 weeks, p < 0.001). CONCLUSION: WBRT alone is an effective palliative treatment for patients unfit/unsuitable for chemotherapy and low performance status suffering from intracranial LMC. However, prognostic factors should be considered in order to identify patients who are likely to benefit from WBRT.
Authors: W Boogerd; M J van den Bent; P J Koehler; J J Heimans; J J van der Sande; N K Aaronson; A A M Hart; J Benraadt; Ch J Vecht Journal: Eur J Cancer Date: 2004-12 Impact factor: 9.162
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: Ulrich Herrlinger; Heike Förschler; Wilhelm Küker; Richard Meyermann; Michael Bamberg; Johannes Dichgans; Michael Weller Journal: J Neurol Sci Date: 2004-08-30 Impact factor: 3.181
Authors: K Fizazi; B Asselain; A Vincent-Salomon; M Jouve; V Dieras; T Palangie; P Beuzeboc; T Dorval; P Pouillart Journal: Cancer Date: 1996-04-01 Impact factor: 6.860
Authors: W T Sause; J Crowley; H J Eyre; S E Rivkin; R P Pugh; J M Quagliana; S A Taylor; B Molnar Journal: J Neurooncol Date: 1988-09 Impact factor: 4.130
Authors: D Steinmann; D Vordermark; H Geinitz; R Aschoff; A Bayerl; J Gerstein; M Hipp; B van Oorschot; H J Wypior; C Schäfer Journal: Strahlenther Onkol Date: 2012-11-18 Impact factor: 3.621
Authors: Syed M Adil; Sarah E Hodges; Ryan M Edwards; Lefko T Charalambous; Zidanyue Yang; Musa Kiyani; Alexis Musick; Beth A Parente; Hui-Jie Lee; Katherine B Peters; Peter E Fecci; Shivanand P Lad Journal: Neurooncol Pract Date: 2020-07-21