How is leptomeningeal disease treated?

How is leptomeningeal disease treated?

A combination of surgery, radiation, and chemotherapy treatment improves the prognosis for leptomeningeal disease. Some tumor types are especially sensitive to chemotherapy injected directly into the cerebrospinal fluid, either by lumbar puncture (“spinal tap”) or through a surgically implanted device called an Ommaya.

Can you survive Leptomeningeal cancer?

Despite advances in targeted radiation and chemotherapy, survival remains poor after diagnosis of leptomeningeal involvement, averaging 3–6 months. Survival varies by etiology, with breast cancer patients having the best prognosis (13–25% survival at one year and 6% at two years) [1, 4, 5].

How do you treat patients with leptomeningeal metastases?

Treatment of leptomeningeal metastases (LM) is individualized based on factors including histology, prognosis, presence of bulky CNS disease, and the state of systemic disease. Treatment modalities may include systemic chemotherapy, radiation therapy, use of targeted agents, intrathecal therapy, and immunotherapy.

Is leptomeningeal disease rare?

The occurrence of leptomeningeal metastases (LM) is a rare complication of cancer in which the disease spreads to the membranes (meninges) surrounding the brain and/or spinal cord. LM occurs in approximately 5–8% of people with solid tumors and is usually terminal.

Can leptomeningeal go away?

Goals for treatment include prolonging survival and stabilizing neurological symptoms. While there’s no cure for leptomeningeal disease yet, radiation and chemotherapy are the two most common treatments.

Is leptomeningeal metastases curable?

What is leptomeningeal melanoma?

Leptomeningeal metastasis, also known as carcinomatous meningitis, occurs secondary to the dissemination of cancer cells into the pia-arachnoid meninges and/or cerebrospinal fluid. Leptomeningeal disease most commonly occurs in patients with melanoma and lung cancer (Pape et al., 2012; Raizer et al., 2008).

Can you survive leptomeningeal metastases?

Since leptomeningeal disease cancer cells float in the cerebrospinal fluid, they can quickly spread throughout the central nervous system. As a result, leptomeningeal disease has a poor prognosis, with survival typically measured in months.

What are the treatment options for leptomeningeal metastases from solid cancers?

Cerebrospinal radiotherapy is rarely an option for adult patients with leptomeningeal metastases from solid cancers because of the risk of bone marrow toxicity, enteritis and mucositis in a context of concomitant systemic disease and the need of systemic pharmacotherapy. Combination of treatment

Is Interleukin-2 an effective treatment for leptomeningeal disease in patients with melanoma?

The role of intrathecal (IT) use of interleukin-2 (IL-2) in the treatment of leptomeningeal disease (LMD) in patients (pts) with melanoma. Proceedings of the American Society of Clinical Oncology, 21, 353a .

What is the prognosis of leptomeningeal disease (LMD)?

Leptomeningeal disease (LMD) patients have a dismal prognosis (Davies et al., 2011) generally measured in weeks. Outcomes have been poor in part because treatment options and clinical trials in LMD have been extremely limited; NCCN guidelines recommend supportive care and/or palliative radiation.

What is the role of systemic pharmacotherapy in leptomeningeal lesions?

Systemic pharmacotherapy, if active, should cover leptomeningeal lesions with contrast enhancement, reflecting absence of an intact blood–brain or spinal cord barrier, because such pharmacotherapy should reach sites of disease just as good as intravenously administered contrast agent.

Begin typing your search term above and press enter to search. Press ESC to cancel.

Back To Top