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J Korean Cancer Assoc > Volume 33(1); 2001 > Article
Journal of the Korean Cancer Association 2001;33(1): 34-40.
Leptomeningeal Carcinomatosis in Solid Tumors; Clinical Manifestation and Treatment
Joon Oh Park, Hyun Joon Shin, Hyung Jong Kim, Sang Wook Lee, Hei Cheul Jeung, Seung Min Kim, Nae Choon Yoo, Hyun Cheol Chung, Joo Hang Kim, Byung Soo Kim, Jin Sik Min, Jae Kyung Roh
1Yonsei Cancer Center.
2Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
3Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Korea.
4Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.
Leptomeningeal carcinomatosis occurs in about 5% of patients with solid tumor and is being diagnosed with increasing frequency as patients live longer and as neuro-imaging studies improve. In general, the most commom cancers that involved the leptomeninges are breast cancer, lung cancer, and malignant melanoma.
We investigated 25 patients presented with multiple neurologic symptoms and signs who were diagnosed with leptomeningeal carcinomatosis at the Yonsei Cancer Center from January 1990 to December 1999.
The primary disease of leptomeningeal carcinomatosis were stomach cancer (10 cases), breast cancer (7 cases), lung cancer (5 cases), unknown primary cancer (2 cases) and common bile duct cancer (1 case). All patients were presented with multiple neurologic symptoms and signs involving the central nervous system (CNS), cranial nerve or spinal nerves. Twenty-one of twenty- five patients were treated with intrathecal chemotherapy, radiotherapy, or combination therapy. Fourteen of them (66.7%) experienced improvement or stabilization of neurologic symptom and sign. The median survival was 122 days (10-2190).
In conclusion, although early diagnosis and active treatment of leptomeningeal carcinomatosis may improve the quality of life in selected patients, the median survival was relatively short. Therefore, new diagnostic and therapeutic strategy for leptomeningeal carcinomatosis were needed.
Key words: Leptomeningeal carcinomatosis;Intrathecal chemotherapy;Radiotherapy
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