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Diagnosis and treatment of leptomeningeal carcinomatosis in solid tumors


Authors: F. Janků;  L. Petruželka
Authors place of work: Onkologická klinika 1. LF UK a VFN, Praha
Published in the journal: Cesk Slov Neurol N 2007; 70/103(1): 23-29
Category: Review Article

Vytvořeno s podporou výzkumného záměru MSM0021620808

Summary

Leptomeningeal carcinomatosis or leptomeningeal metastases occur in approximately 4-15% patients with solid tumors. Nowadays, this disorder is more frequently diagnosed with longer survival of cancer patients and constantly improving diagnostic methods. The most common cancers to involve leptomeninges are breast cancer, lung cancer and melanoma. Clinically, patients with leptomeningeal carcinomatosis present with various neurological symptoms including headache, back pain, head nerves injuries, diplopia etc. Cerebrospinal fluid (CSF) cytology is a principal method in diagnosis. Magnetic resonance imaging is a major method among radiologic studies. Without treatment, the median survival of untreated patients is 4-6 weeks and death occurs from progressive neurologic dysfunction. Intrathecal chemotherapy with or without involved field radiotherapy may extend survival up to 4 to 6 months. Chemotherapy is usually administered via subcutaneous reservoir and ventricular catheter. Radionuclide CSF flow study should precede the treatment. At present, methotrexate is mostly used for intrathecal chemotherapy of solid tumors. This therapy is frequently accompanied by an arachnoiditis, leukoencephalopathy, myelopathy or infection.

Key words:
leptomeningeal carcinomatosis; leptomeningeal metastases; intrathecal chemotherapy; methotrexate, cytosine arabinosid; cerebrospinal fluid


Zdroje

1. Chamberlain MC. Neoplastic meningitis. J Clin Oncol 2005; 23: 3605-13.

2. Nugent JL, Bunn PA Jr, Matthews MJ et al. CNS metastases in small cell bronchogenic carcinoma: Increasing frequency and changing pattern with lengthening survival. Cancer 1979; 44: 1885-93.

3. Kaplan JG, DeSouza TG, Farkash A et al. Leptomeningeal metastases: Comparison of clinical features and laboratory data of solid tumors, lymphomas and leukemias. J Neurooncol 1990; 9: 225-9.

4. Chamberlain MC. Carcinomatous meningitis. Arch Neurol 1997; 54: 16-17.

5. Glass JP, Melamed M, Chernik NL et al. Malignant cells in cerebrospinal fluid (CSF): The meaning of a positive CSF cytology. Neurology 1979; 29: 1369-75.

6. Wasserstrom WR, Glass JP, Posner JB. Diagnosis and treatment of leptomeningeal metastases from solid tumors: Experience with 90 patients. Cancer 1982; 49: 759-72.

7. Balm M, Hammack J. Leptomeningeal carcinomatosis: Presenting features and prognostic factors. Arch Neurol 1996; 53: 626-32.

8. Janků F, Dušková J, Petruželka L et al. Meningeal carcinomatosis as the first manifestation of gastric adenocarcinoma. Čas Lék Česk 2001; 140: 636-9.

9. Gonzalez-Vitale JC, Garcia-Bunuel R. Meningeal carcinomatosis. Cancer 1976; 37: 2906-11.

10. Grossman SA, Krabak MJ. Leptomeningeal carcinomatosis. Cancer Treat Rev 1999; 25: 103-19.

11. Chamberlain MC. Radioisotope CSF flow studies in leptomeningeal metastases. J Neurooncol 1998; 38: 135-40.

12. Norris LK, Grossman SA, Olivi A. Neoplastic meningitis following surgical resection of isolated cerebellar metastases: A potentially preventable complication. J Neuro-Oncol 1997; 32: 215–23.

13. Boyle R, Thomas M, Adams JH. Diffuse involvement of the leptomeninges by tumour: A clinical and pathological study of 63 cases. Postgrad Med J 1980; 56: 149-58. ¨

14. DeAngelis LM. Current diagnosis and treatment of leptomeningeal metastasis. J Neurooncol 1998; 38: 245–52.

15. Jayson GC, Howell A. Carcinomatous meningitis in solid tumors. Ann Oncol 1996; 7: 773–86.

16. Olson ME, Chernik NL, Posner JB. Infiltration of the leptomeninges by systemic cancer. A clinical and pathologic study. Arch Neurol 1974; 30: 122–37.

17. Theodore WH, Gendelman S. Meningeal carcinomatosis. Arch Neurol 1981; 38: 696–9.

18. Twijnstra A, Ongerboer dr Visser BW, van Zanten AP. Diagnosis of leptomeningeal metastasis. Clin Neurol Neurosurg 1987; 89: 79–85.

19. Doležil D, Čuřík R, Nováčková L et al. Úskalí diagnostiky leptomeningeálních metastáz. Neurologie pro praxi 2002; 2: 99-101.

20. Reuler JB, Meier D. Leptomeningeal carcinomatosis with normal CSF features. Arch Intern Med 1979; 139: 237–8.

21. Adam P. Cytologie likvoru. Pardubice: STAPRO 1995.

22. Davies SF, Gormus BJ, Yarchoan R. Cryptococcal meningitis with false-positive cytology in the CSF: Use of T-cell rosetting to exclude meningeal lymphoma. JAMA 1978; 239: 2369–70.

23. Rawlinson DG, Billingham ME, Berry PF. Cytology of the cerebrospinal fluid in patients with Hodgkin’s disease or malignant lymphoma. Acta Neuropathol (Berl) 1975; 6: 187–91.

24. Ehya H, Hajdu SI, Melamed MR. Cytopathology of nonlymphoreticular neoplasms metastatic to the central nervous system. Acta Cytol 1981; 25: 599–610.

25. Murray JJ, Greco FA, Wolff SN et al. Neoplastic meningitis. Marked variation of cerebrospinal fluid composition in the absence of extradural block. Am J Med 1978; 75: 289–94.

26. Chamberlain MC. Cytologically negative carcinomatous meningitis: usefulness of CSF biochemical markers. Neurology 1998; 50: 1173–5.

27. Jacobi C, Reiber H, Felgenhauer K. The clinical relevance of locally produced carcinoembryonic antigen in cerebrospinal fluid. J Neurol 1986; 233: 358–61.

28. Shuttleworth E, Allen N. CSF beta-glucuronidase assay in the diagnosis of neoplastic meningitis. Arch Neurol 1980; 37: 684–7.

29. Tallman RD, Kimbrough SM, O'Brien JF et al. Assay for betaglucuronidase in cerebrospinal fluid. Usefulness for the detection of neoplastic meningitis. Mayo Clin Proc 1985; 60: 293–8.

30. Twijnstra A, van Zanten AP, Hart AA et al. Serial lumbar and ventricle cerebrospinal fluid lactate dehydrogenase activities in patients with leptomeningeal metastases from solid and haematological tumours. J Neurol Neurosurg Psychiatry 1987; 50: 313–20.

31. Twijnstra A, van Zanten AP, Nooven WJ. Sensitivity and specificity of single and combined tumour markers in the diagnosis of leptomeningeal metastasis from breast cancer. J Neurol Neurosurg Psychiatry 1986; 49: 1246–50.

32. Adachi N. Beta-2-microglobulin levels in the cerebrospinal fluid. their value as a disease marker. Eur Neurol 1991; 31: 181–5.

33. Jeffery GM, Frampton CM, Legge HM et al. Cerebrospinal fluid B2-microglobulin levels in meningeal involvement by malignancy. Pathology 1990; 22: 20–3.

34. Garson JA, Coakham HB, Kemshead JT et al. The role of monoclonal antibodies in brain tumour diagnosis and cerebrospinal fluid (CSF) cytology. J Neurooncol 1985; 3: 165-71.

35. Hovestadt A, Henzen-Logmans SC, Vecht CJ. Immunohistochemical analysis of the cerebrospinal fluid for carcinomatous and lymphomatous leptomeningitis. Br J Cancer 1990; 62: 653-4.

36. Boogerd W, Vroom TM, van Heerde P et al. CSF cytology versus immunocytochemistry in meningeal carcinomatosis. J Neurol Neurosurg Psychiatry 1988; 51: 142-5.

37. Van Oostenbrugge RJ, Hopman AH, Ramaekers FC et al. In situ hybridization: A possible diagnostic aid in leptomeningeal metastasis. J Neurooncol 1998; 38: 127-33.

38. Van Oostenbrugge RJ, Hopman AH, Arends JW et al. The value of interphase cytogenetics in cytology for the diagnosis of leptomeningeal metastases. Neurology 1998; 51: 906-8.

39. Schumacher M, Orszagh M. Imaging techniques in neoplastic meningiosis. J Neurooncol 1998; 38: 111-20.

40. Chamberlain MC, Sandy AD, Press GA. Leptomeningeal metastasis: A comparison of gadolinium-enhanced MR and contrast-enhanced CT of the brain. Neurology 1990; 40: 435-8.

41. Sze G, Soletsky S, Bronen R et al. MR imaging of the cranial meninges with emphasis on contrast enhancement and meningeal carcinomatosis. Am J Roentgenol 1989; 153: 1039-49.

42. Schuknecht B, Huber P, Buller B et al. Spinal leptomeningeal neoplastic disease: Evaluation by MR, myelography and CT myelography. Eur Neurol 1992; 32: 11-6.

43. Chamberlain MC. Comparative spine imaging in leptomeningeal metastases. J Neurooncol 1995; 23: 233-8.

44. Doležil D, Čuřík R, Doležilová V et al. Clinical picture and diagnostic algorithm of leptomeningeal metastases. Eur J Neurol 2003; 10(Suppl 1): 184.

45. Glantz MJ, Hall WA, Cole BF et al. Diagnosis, management, and survival of patients with leptomeningeal cancer based on cerebrospinal fluid-flow status. Cancer 1995; 75: 2919-31.

46. Chamberlain MC, Kormanik PA. Prognostic significance of 111indium-DTPA CSF flow studies in leptomeningeal metastases. Neurology 1996; 46: 1674-7.

47. Mason WP, Yeh SD, DeAngelis LM. 111Indium-diethylenetriamine pentaacetic acid cerebrospinal fluid flow studies predict distribution of intrathecally administered chemotherapy and outcome in patients with leptomeningeal metastases. Neurology 1998; 50: 438-44.

48. Chamberlain MC, Corey-Bloom J. Leptomeningeal metastases: 111indium-DTPA CSF flow studies. Neurology 1991; 41: 1765-9.

49. Chamberlain MC, Kormanik P, Jaeckle KA et al. 111Indium-diethylenetriamine pentaacetic acid CSF flow studies predict distribution of intrathecally administered chemotherapy and outcome in patients with leptomeningeal metastases. Neurology 1999; 52: 216-7.

50. Chamberlain MC, Kormanik PR. Carcinomatous meningitis secondary to breast cancer: Predictors of response to combined modality therapy. J Neurooncol 1997; 35: 55-64.

51. Chamberlain MC, Kormanik P. Carcinoma meningitis secondary to non-small cell lung cancer: Combined modality therapy. Arch Neurol 1998; 55: 506-12.

52. Chamberlain MC. Neoplastic meningitis–related encephalopathy: Prognostic significance. Neurology 2003; 60: A17-18.

53. Shapiro WR, Posner JB, Ushio Y et al. Treatment of meningeal neoplasms. Cancer Treat Rep 1977; 61: 733–43.

54. Grossman SA, Moynihan TJ. Neoplastic meningitis. Neurology Clinics of North America 1991; 9: 843–56.

55. Sause WT, Crowley J, Eyre HJ et al. Whole brain irradiation and intrathecal methotrexate in the treatment of solid tumor leptomeningeal metastases: A Southwest Oncology Group study. J Neurooncol 1988; 6: 107-12.

56. Shapiro WR, Young DF, Mehta BM. Methotrexate: Distribution in cerebrospinal fluid after intravenous, ventricular and lumbar injections. N Engl J Med 1975; 293: 161–6.

57. Bleyer WA, Poplack DG. Intraventricular versus intralumbar methotrexate for CNS leukemia: Prolonged remission with the Ommaya reservoir. Med Pediatr Oncol 1979; 6: 207–13.

58. Haghbin M, Galicich JH. Use of the Ommaya reservoir in prevention and treatment of CNS leukemia. Am J Pediatr Hematol Oncol 1979; 1: 111–7.

59. Rogers LR, Duchesneau PM, Nunez C et al. Comparison of cisternal and lumbar CSF examination in leptomeningeal metastasis. Neurol 1992; 42: 1239–41.

60. Bleyer WA, Drake JC, Chabner BA. Neurotoxicity and elevated cerebrospinal fluid methotrexate concentration in meningeal leukemia. N Engl J Med 1973; 289: 770–3.

61. Hitchins RN, Bell DR, Woods RL et al. Aprospective randomized trial of single-agent versus combination chemotherapy in meningeal carcinomatosis. J Clin Oncol 1987; 5: 1655–62.

62. Grochow LB, Grossman SA, Garrett S. Pharmacokinetics of Intraventricular Thiotepa (TT) in Patients with Meningeal Carcinomatosis. Proc Am Soc Clin Oncol 1982; 1: 19.

63. Gutin PH, Weiss HD, Wiernik PH et al. Intrathecal N, N‘, N‘‘- triethylenethiophosphoramide {thio- TEPA(NSC 6396)} in the treatment of malignant meningeal disease: Phase I–II study. Cancer 1976; 38: 1471–5.

64. Grossman SA, Finkelstein DM, Ruckdeschel JC et al. Randomized prospective comparison of intraventricular methotrexate and thiotepa in patients with previously untreated neoplastic meningitis. J Clin Oncol, 1993; 11: 561–9.

65. Stewart DJ, Maroun JA, Hugenholtz H et al. Combined intraommaya methotrexate, cytosine arabinoside, hydrocortisone and thio-TEPA for meningeal involvement by malignancies. J Neurooncol. 1987; 5: 315-22.

66. Giannone L, Greco FA, Hainsowrth JD. Combination intraventricular chemotherapy for meningeal neoplasia. J Clin Oncol 1986; 4: 68–73.

67. Glantz MJ, Jaeckle KA, Chamberlain MC et al. A randomized controlled trial comparing intrathecal sustained-release cytarabine (DepoCyt) to intrathecal methotrexate in patients with neoplastic meningitis from solid tumors. Clin Cancer Res 1999; 5: 3394-402.

68. Jaeckle KA, Batchelor T, O'Day SJ et al. An open label trial of sustained-release cytarabine (DepoCyt) for the intrathecal treatment of solid tumor neoplastic meningitis. J Neurooncol 2002; 57: 231-9.

69. Glantz MJ, LaFollette S, Jaeckle KA et al. Randomized trial of a slow release versus a standard formulation of cytarabine for the intrathecal treatment of lymphomatous meningitis. J Clin Oncol 1999; 17: 3110-6.

70. Blaney SM, Poplack DG. New cytotoxic drugs for intrathecal administration. J Neurooncol 1998; 38: 219-23.

71. Sampson JH, Archer GE, Villavicencio AT et al. Treatment of neoplastic meningitis with intrathecal temozolomide. Clin Cancer Res 1999; 5: 1183-8.

72. Herrlinger U, Weller M, Schabet M. New aspects of immunotherapy of leptomeningeal metastasis. J Neurooncol 1998; 38: 233-9.

73. Coakham HB, Kemshead JT. Treatment of neoplastic meningitis by targeted radiation using 131I-radiolabelled monoclonal antibodies. J Neurooncol 1998; 38: 225-32.

74. Vrionis FD. Gene therapy of neoplastic meningiosis. J Neurooncol 1998; 38: 241-4.

75. Chamberlain MC, Kormanik PA, Barba D. Complications associated with intraventricular chemotherapy in patients with leptomeningeal metastases. J Neurosurg 1997; 87: 694-9.

76. Sandberg DI, Bilsky MH, Souweidane MM et al. Ommaya reservoirs for the treatment of leptomeningeal metastases. Neurosurgery 2000; 47: 49-54.

77. Kerr JZ, Berg S, Blaney SM. Intrathecal chemotherapy. Crit Rev Oncol Hematol 2001; 37: 227-36.

Štítky
Paediatric neurology Neurosurgery Neurology

Článok vyšiel v časopise

Czech and Slovak Neurology and Neurosurgery

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2007 Číslo 1
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