title: Carcinomatous meningitis: are surgeryand gamma knife radiosurgery treatment risk factors?
abstract: OBJECTIVE
  The purpose of this study was to identify possible risk factors leading to carcinomatous meningitis in patients with a known brain metastasis and who were treated with gamma knife radiosurgery (GKS).
  
  
  METHODS
  Two hundred eighty lesions in 101 patients were treated during 121 GKS procedures. The clinical and neuroimaging history, tumor histology, and follow-up studies were reviewed for all patients. Evidence as demonstrated by magnetic resonance imaging criteria and/or cerebrospinal fluid (CSF) cytology of carcinomatous meningitis was evaluated. The data were then analyzed to identify potential risk factors for the development of CSF dissemination.
  
  
  CONCLUSIONS
  It appears that carcinomatous meningitis is exclusively identified in patients with adenocarcinoma, in particular with primary lung cancer. Furthermore, the incidence is higher if surgery is performed and the interval to subsequent GKS is prolonged.
authors.affiliation: Department of Radiation Oncology, Tufts-New England Medical Center, Tufts University, Boston, Massachusetts 02111, USA. amahajan@lifespan.org
authors.forename: Anita
authors.initials: A
authors.lastname: Mahajan
authors.forename: Jonathan
authors.initials: J
authors.lastname: Borden
authors.forename: Jen-San
authors.initials: JS
authors.lastname: Tsai
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality* / Q000556:secondary / Q000601:surgery; D001932:Brain Neoplasms / Q000401:mortality* / Q000556:secondary / Q000601:surgery; D001943:Breast Neoplasms / Q000473:pathology; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000556:secondary / Q000601:surgery; D018288:Carcinoma, Small Cell / Q000401:mortality / Q000556:secondary / Q000601:surgery; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008175:Lung Neoplasms / Q000473:pathology*; D008581:Meningitis / Q000209:etiology / Q000401:mortality*; D018307:Neoplasms, Squamous Cell / Q000401:mortality / Q000556:secondary / Q000601:surgery; D016634:Radiosurgery / Q000009:adverse effects*; D012307:Risk Factors; D016019:Survival Analysis