A retrospective case series of 103 consecutive patients with leptomeningeal metastasis and breast cancer
| Autor: | Marie-Christine Baranzelli, Richard Assaker, Nuria Kotecki, Thomas Boulanger, S. Taillibert, L. Vanlemmens, Marc C. Chamberlain, Patrick Devos, P. Vennin, F. Dubois, Audrey Mailliez, Fahed Zairi, Guillaume Marliot, Charles Andre, J. L. Cazin, Véronique Servent, Jacques Bonneterre, E. Le Rhun |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
Cancer Research medicine.medical_specialty medicine.medical_treatment Antineoplastic Agents Breast Neoplasms ThioTEPA Kaplan-Meier Estimate Gastroenterology Disease-Free Survival Breast cancer Internal medicine medicine Humans Injections Spinal Aged Proportional Hazards Models Retrospective Studies Performance status business.industry Cytarabine Retrospective cohort study Middle Aged medicine.disease Surgery Radiation therapy Meningeal carcinomatosis Neurology Oncology Liposomes Methotrexate Female Neurology (clinical) business Meningeal Carcinomatosis medicine.drug |
| Zdroj: | Journal of neuro-oncology. 113(1) |
| ISSN: | 1573-7373 |
| Popis: | Approximately 2–5 % of patients with breast cancer (BC) develop leptomeningeal metastasis (LM). 103 consecutive patients with BC were diagnosed with LM and initially treated with intra-CSF liposomal cytarabine from 2007 to 2011 at a single institution. Correlations were determined with respect to patient characteristics and BC subtype with regard to overall survival (OS). At LM diagnosis, 61 % of patients had a 0–2 performance status (PS), the remaining 39 % were severely neurologically impaired. Regardless of PS, all patients received intra-cerebrospinal fluid (CSF) liposomal cytarabine as first-line treatment. Systemic treatment and radiotherapy were also given in 58 and 17 % of patients respectively as clinically appropriate. Second- (intra-CSF thiotepa) and third-line (intra-CSF methotrexate) treatment was administered in 24 and 6 patients respectively. Median OS was 3.8 months (range 1 day–2.8 years). In multivariate analysis, an initial combined treatment, a second-line treatment with intra-CSF thiotepa, an initial clinical response, and a non-‘ER/PR/HER2 negative’ BC were significantly associated with a better OS. Median OS in this heterogeneous retrospective case series was similar to that of previously observed BC patients treated with intra-CSF methotrexate suggesting intra-CSF liposomal cytarabine is a reasonable first choice therapy of BC-related LM. |
| Databáze: | OpenAIRE |
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