Helical tomotherapy in patients with leptomeningeal metastases
Purpose: Leptomeningeal metastasis (LM) is an increasingly common complication of late-stage systemic cancer, for which there is no standard treatment. We analyzed outcome and toxicity in patients with LM undergoing craniospinal irradiation via helical tomotherapy (HT-CSI) at our institution. Patien...
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| Hauptverfasser: | , , , , , , |
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| Dokumenttyp: | Article (Journal) |
| Sprache: | Englisch |
| Veröffentlicht: |
2019
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| In: |
Cancer management and research
Year: 2018, Jahrgang: 11, Pages: 401-409 |
| ISSN: | 1179-1322 |
| DOI: | 10.2147/CMAR.S185414 |
| Online-Zugang: | Verlag, kostenfrei, Volltext: https://doi.org/10.2147/CMAR.S185414 Verlag, kostenfrei, Volltext: https://www.dovepress.com/helical-tomotherapy-in-patients-with-leptomeningeal-metastases-peer-reviewed-fulltext-article-CMAR 
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| Verfasserangaben: | Sanziana R I Schiopu, Gregor Habl, Matthias Haefner, Sonja Katayama, Klaus Herfarth, Juergen Debus, Florian Sterzing |
| Zusammenfassung: | Purpose: Leptomeningeal metastasis (LM) is an increasingly common complication of late-stage systemic cancer, for which there is no standard treatment. We analyzed outcome and toxicity in patients with LM undergoing craniospinal irradiation via helical tomotherapy (HT-CSI) at our institution. Patients and methods: The charts of 15 patients diagnosed with LM and undergoing HT-CSI between 2006 and 2014 were retrospectively assessed. Main neoplasms included breast cancer, lung cancer, and lymphoma. All patients presented with cranial neuropathy due to LM. Follow-up was performed regularly. Survival analysis was performed by the Kaplan–Meier method, and prognostic factors were tested using the COX-regression model. Results: Median survival by cancer type was 6 (breast cancer), 1 (lung cancer), and 2 months (lymphoma), respectively. Median overall survival and relapse-free survival were calculated to be between 2 and 3 months. Six- and 12-month survival was 30% (95% CI 0.08–0.5) and 20% (95% CI 0.05–0.4), respectively. Symptom palliation occurred in 53% of patients in general, but in 67% of breast cancer patients, in particular. Patients with lung cancer experienced no improvement. Most common acute treatment-related toxicity at different levels were hematological toxicity, multiple cranial neuropathy, fatigue, infections, nausea, and headache. Conclusion: HT-CSI can help meet the challenge of treating patients with LM, especially because it can palliate symptoms and improve neurological functions. One-year survival remains as disappointing as before. Keywords: craniospinal irradiation, radiotherapy, palliative care, neoplastic meningitis, breast cancer |
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| Beschreibung: | Published 31 December 2018 Gesehen am 31.05.2019 |
| Beschreibung: | Online Resource |
| ISSN: | 1179-1322 |
| DOI: | 10.2147/CMAR.S185414 |