Helical tomotherapy in patients with leptomeningeal metastases

• Verfasst von: Schiopu, Sanziana [VerfasserIn]
• Verfasst von: Habl, Gregor [VerfasserIn]
• Verfasst von: Häfner, Matthias [VerfasserIn]
• Verfasst von: Katayama, Sonja [VerfasserIn]
• Verfasst von: Herfarth, Klaus [VerfasserIn]
• Verfasst von: Debus, Jürgen [VerfasserIn]
• Verfasst von: Sterzing, Florian [VerfasserIn]
• Titel: Helical tomotherapy in patients with leptomeningeal metastases
• Verf.angabe: Sanziana R I Schiopu, Gregor Habl, Matthias Haefner, Sonja Katayama, Klaus Herfarth, Juergen Debus, Florian Sterzing
• Jahr: 2019
• Jahr des Originals: 2018
• Umfang: 9 S.
• Fussnoten: Published 31 December 2018 ; Gesehen am 31.05.2019
• Titel Quelle: Enthalten in: Cancer management and research
• Ort Quelle: Albany, Auckland : Dove Medical Press, 2009
• Jahr Quelle: 2019
• Band/Heft Quelle: 11(2019), Seite 401-409
• ISSN Quelle: 1179-1322
• DOI: doi:10.2147/CMAR.S185414
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1666578843
• K10plus-PPN:
  Universitätsbibliothek
• Lokale URL UB: Zum Volltext

Abstract

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