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Impact of Multimodality Approach for Patients with Leptomeningeal Metastases from Solid Tumors

Cited 11 time in Web of Science Cited 12 time in Scopus
Authors
Kwon, Jeanny; Chie, Eui Kyu; Kim, Kyubo; Kim, Hak Jae; Wu, Hong-Gyun; Kim, Il Han; Oh, Do-Youn; Lee, Se-Hoon; Kim, Dong-Wan; Im, Seock-Ah; Kim, Tae-You; Heo, Dae-Seog; Bang, Yung-Jue; Ha, Sung W.
Issue Date
2014-08
Citation
Journal of Korean Medical Science, Vol.29 No.8, pp.1094-1101
Keywords
Leptomeningeal MetastasesPrognostic FactorSolid Tumor
Abstract
The purpose of this study was to evaluate treatment patterns, outcome and prognosticators for patients with leptomeningeal metastases from solid tumor. Medical records of 80 patients from January 1, 2004 to May 31, 2011 were retrospectively reviewed. Most frequent site of origin was the lung (59%) followed by the breast (25%). Most patients were treated with intrathecal chemotherapy (90%) and/or whole brain radiotherapy (67.5%). Systemic therapy was offered to 27 patients (33.8%). Percentage of patients treated with single, dual, and triple modality were 32.5%, 43.8%, and 23.8%, respectively. Median survival was 2.7 months and 1 yr survival rate was 11.3%. Multivariate analysis showed that negative cerebrospinal fluid cytology, fewer chemotherapy regimen prior to leptomeningeal metastases, whole brain radiotherapy, systemic therapy, and combined modality treatment (median survival; single 1.4 vs. dual 2.8 vs. triple 8.3 months, P < 0.001) had statistical significance on survival. Subgroup analysis of non-small cell lung cancer (NSCLC) patients showed that targeted therapy had significant independent impact on survival (median survival; 10.5 vs. 3.0 months, P = 0.008). Unlike previous reports, survival of patients with NSCLC primary was comparable to breast primary. Furthermore, combined modality treatment for all patients and additionally targeted therapy for NSCLC patients should be considered in the treatment of leptomeningeal metastases from solid tumor.
ISSN
1011-8934
URI
http://hdl.handle.net/10371/165410
DOI
https://doi.org/10.3346/jkms.2014.29.8.1094
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College of Medicine/School of Medicine (의과대학/대학원)Internal Medicine (내과학전공)Journal Papers (저널논문_내과학전공)
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