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J Clin Neurosci. 2015 Apr;22(4):632-7. doi: 10.1016/j.jocn.2014.10.022. Epub 2015 Feb 9.

Treatment of leptomeningeal carcinomatosis: current challenges and future opportunities.

Author information

1
University of Chicago, Department of Neurology, 5841 S. Maryland Avenue, MC 2030, Chicago, IL 60637, USA.
2
University of Chicago, Section of Hematology and Oncology, Chicago, IL, USA.
3
University of Virginia, Division of Hematology and Oncology, Charlottesville, VA, USA.
4
University of Chicago, Department of Neurology, 5841 S. Maryland Avenue, MC 2030, Chicago, IL 60637, USA. Electronic address: rlukas@neurology.bsd.uchicago.edu.

Abstract

Leptomeningeal metastasis (LM) in breast cancer patients confers a uniformly poor prognosis and decreased quality of life. Treatment options are limited and often ineffective, due in large part to limitations imposed by the blood-brain barrier and the very aggressive nature of this disease. The majority of studies investigating the treatment of LM are not specific to site of origin. Conducting randomized, disease-specific clinical trials in LM is challenging, and much clinical outcomes data are based on case reports or retrospective case series. Multiple studies have suggested that chemo-radiotherapy is superior to either chemotherapy or radiation therapy alone. Attempts to overcome current obstacles in the treatment of breast cancer LM hold promise for the future. We review the epidemiology, diagnosis, and prognosis of LM in breast cancer, and discuss the treatment options currently available as well as those under investigation.

KEYWORDS:

Breast cancer; Carcinomatous meningitis; Chemotherapy; Intrathecal therapy; Leptomeningeal carcinomatosis; Radiotherapy

PMID:
25677875
DOI:
10.1016/j.jocn.2014.10.022
[Indexed for MEDLINE]

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