Prophylaxis and treatment of leptomeningeal carcinomatosis in solid tumors of adulthood.

Despite the lack of randomized and prospective studies the benefit of MC therapy can not be attributed merely to patient selection, since substantial increase of survival time and long term survivors are seen only in patients who have received, and responded to treatment. In the absence of factors predicting the therapeutic response, all patients with overt MC should be treated with the possible exception of these with widespread and uncontrolled systemic neoplasia. The respective weight of systemic and intraventricular chemotherapy, and radiation therapy, remains unclear. It may depend upon the stage and the nature of the primary neoplasia. When intraventricular MTX is used, monitoring of drug concentrations is advised.