2.50
Hdl Handle:
http://hdl.handle.net/10541/96016
Title:
Carcinomatous meningitis in solid tumours.
Authors:
Jayson, Gordon C ( 0000-0002-8515-8944 ) ; Howell, Anthony ( 0000-0002-3879-5991 )
Abstract:
Carcinomatous meningitis (CM) is an uncommon but devastating complication of malignancy. The management is controversial and clear recommendations cannot be made because: 1) Most series include patients with CM that has arisen from different primary malignancies which are associated with different median survival intervals. 2) There have been no prospective randomised investigations of treatment modalities in patients with CM from a particular tumour type. 3) The definition of response varies from one report to another so that some response rates refer to cytological changes in the CSF while others take clinical, cytological and biochemical parameters into account. 4) Reports include patients with and without parenchymal metastases and the natural history of carcinomatous meningitis in the two situations may differ. The median survival of solid tumour carcinomatous meningitis (excluding leukaemia and lymphoma) is approximately 2-3 months and patients with breast cancer have the longest survival (median 3 months). Currently patients are treated with radiotherapy to part or all of the neuraxis with either intrathecal or intravenous chemotherapy but the relative contribution of these modalities to survival or quality of life remains unknown. Approximately 50% of patients with carcinomatous meningitis die from other causes, including systemic disease. The two most important endpoints for the patient, neurological improvement and overall survival, are seldom used in isolation in the literature. Many reports have focused on surrogate markers of response, namely biochemical and cytological data points but the correlation between clinical status and these parameters is poor because of differences between lumbar and ventricular CSF and disturbances of CSF flow in CM. The current literature does not provide clear guidelines for the treatment of this condition. Multicentre, prospective, randomised trials should be conducted that address questions of most relevance to the patient, namely neurological status and overall survival.
Affiliation:
Department of Medical Oncology, Christie Hospital and NHS Trust, Withington, Manchester, UK.
Citation:
Carcinomatous meningitis in solid tumours. 1996, 7 (8):773-86 Ann. Oncol.
Journal:
Annals of Oncology
Issue Date:
Oct-1996
URI:
http://hdl.handle.net/10541/96016
PubMed ID:
8922190
Type:
Article
Language:
en
ISSN:
0923-7534
Appears in Collections:
All Christie Publications

Full metadata record

DC FieldValue Language
dc.contributor.authorJayson, Gordon Cen
dc.contributor.authorHowell, Anthonyen
dc.date.accessioned2010-04-08T13:59:42Z-
dc.date.available2010-04-08T13:59:42Z-
dc.date.issued1996-10-
dc.identifier.citationCarcinomatous meningitis in solid tumours. 1996, 7 (8):773-86 Ann. Oncol.en
dc.identifier.issn0923-7534-
dc.identifier.pmid8922190-
dc.identifier.urihttp://hdl.handle.net/10541/96016-
dc.description.abstractCarcinomatous meningitis (CM) is an uncommon but devastating complication of malignancy. The management is controversial and clear recommendations cannot be made because: 1) Most series include patients with CM that has arisen from different primary malignancies which are associated with different median survival intervals. 2) There have been no prospective randomised investigations of treatment modalities in patients with CM from a particular tumour type. 3) The definition of response varies from one report to another so that some response rates refer to cytological changes in the CSF while others take clinical, cytological and biochemical parameters into account. 4) Reports include patients with and without parenchymal metastases and the natural history of carcinomatous meningitis in the two situations may differ. The median survival of solid tumour carcinomatous meningitis (excluding leukaemia and lymphoma) is approximately 2-3 months and patients with breast cancer have the longest survival (median 3 months). Currently patients are treated with radiotherapy to part or all of the neuraxis with either intrathecal or intravenous chemotherapy but the relative contribution of these modalities to survival or quality of life remains unknown. Approximately 50% of patients with carcinomatous meningitis die from other causes, including systemic disease. The two most important endpoints for the patient, neurological improvement and overall survival, are seldom used in isolation in the literature. Many reports have focused on surrogate markers of response, namely biochemical and cytological data points but the correlation between clinical status and these parameters is poor because of differences between lumbar and ventricular CSF and disturbances of CSF flow in CM. The current literature does not provide clear guidelines for the treatment of this condition. Multicentre, prospective, randomised trials should be conducted that address questions of most relevance to the patient, namely neurological status and overall survival.en
dc.language.isoenen
dc.subjectCanceren
dc.subjectMeningeal Canceren
dc.subject.meshAntineoplastic Combined Chemotherapy Protocols-
dc.subject.meshClinical Trials as Topic-
dc.subject.meshHumans-
dc.subject.meshMeningeal Neoplasms-
dc.subject.meshMeningitis-
dc.subject.meshNeoplasms-
dc.subject.meshPrognosis-
dc.subject.meshSurvival Rate-
dc.titleCarcinomatous meningitis in solid tumours.en
dc.typeArticleen
dc.contributor.departmentDepartment of Medical Oncology, Christie Hospital and NHS Trust, Withington, Manchester, UK.en
dc.identifier.journalAnnals of Oncologyen

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