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Leptomeningeal Neoplasms.

Lauren E. Abrey1

  • 1Department of Neurology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021, USA. abreyl@mskcc.org

Current Treatment Options in Neurology
|February 6, 2002
PubMed
Summary

Leptomeningeal metastases, a late-stage cancer complication, present with neurologic symptoms like headache and walking difficulty. Treatment is primarily palliative, focusing on radiotherapy, chemotherapy, and shunting for symptom relief.

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Area of Science:

  • Neuro-oncology
  • Medical oncology
  • Neurology

Background:

  • Leptomeningeal metastases (LM) are a severe complication of systemic cancer, often indicating widespread disease.
  • Neurologic symptoms such as headache, cognitive changes, and gait disturbance are common in LM.
  • Diagnosis relies on neuroimaging and cerebrospinal fluid (CSF) analysis.

Purpose of the Study:

  • To summarize the clinical presentation, diagnosis, and palliative treatment strategies for leptomeningeal metastases.

Main Methods:

  • Review of existing literature on leptomeningeal metastases.
  • Analysis of diagnostic modalities including neuroimaging and CSF analysis.
  • Evaluation of palliative treatment options such as radiotherapy, intrathecal chemotherapy, systemic chemotherapy, and shunting.

Main Results:

  • Prognosis for leptomeningeal metastases is poor, with a median survival of 6-8 weeks.
  • Radiotherapy is indicated for bulky or symptomatic tumor sites.
  • Intrathecal chemotherapy shows efficacy in lymphoma, leukemia, and breast cancer.
  • Systemic chemotherapy may benefit bulky LM.
  • Ventriculoperitoneal shunting is effective for obstructive hydrocephalus or increased intracranial pressure.

Conclusions:

  • Leptomeningeal metastases represent a critical late-stage cancer complication requiring prompt diagnosis and palliative care.
  • Treatment strategies should be tailored to the individual patient, focusing on symptom management and quality of life.
  • Multimodal approaches including radiotherapy, chemotherapy, and surgical intervention offer therapeutic options.

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