Clinical improvement and survival in breast cancer leptomeningeal metastasis correlate with the cytologic response to intrathecal chemotherapy.
Leptomeningeal meningitis occurs in approximately 5% of metastatic breast cancers, and there is no standard treatment for this complication. We retrospectively analyzed the clinical data and cerebrospinal fluid of 24 patients treated with high-dose intrathecal methotrexate for breast cancer leptomeningeal meningitis (BLM). Cytologic response (CSF cytology without neoplastic cells after treatment) was observed in 11 patients (46%) and related to survival (P = 0.005). In addition, clinical symptoms improved in all 11 patients who had a cytologic response and in 7 patients (54%) without cytologic response (P = 0.02). The predictive value of cytologic response needs further confirmation. Cytologic response could be helpful in the management of intrathecal chemotherapy in patients with BLM.
Clatot
Florian
F
Département d'Oncologie Médicale, Centre Henri-Becquerel, Rue d'Amiens, 76038, Rouen Cedex, France.
Philippin-Lauridant
Géraldine
G
Département d'Oncologie Médicale, Centre Henri-Becquerel, Rue d'Amiens, 76038, Rouen Cedex, France.
Ouvrier
Matthieu-John
MJ
Département d'Oncologie Médicale, Centre Henri-Becquerel, Rue d'Amiens, 76038, Rouen Cedex, France.
Nakry
Tony
T
Département d'Oncologie Médicale, Centre Henri-Becquerel, Rue d'Amiens, 76038, Rouen Cedex, France.
Laberge-Le-Couteulx
Sophie
S
Service d'Anatomie et Cytologie Pathologiques, Centre Henri-Becquerel, Rue d'Amiens, 76038, Rouen Cedex, France.
Guillemet
Cécile
C
Département d'Oncologie Médicale, Centre Henri-Becquerel, Rue d'Amiens, 76038, Rouen Cedex, France.
Veyret
Corinne
C
Département d'Oncologie Médicale, Centre Henri-Becquerel, Rue d'Amiens, 76038, Rouen Cedex, France.
Blot
Emmanuel
E
Département d'Oncologie Médicale, Centre Henri-Becquerel, Rue d'Amiens, 76038, Rouen Cedex, France. eblot1@voila.fr.
D000328:Adult; D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage* / Q000009:adverse effects; D001943:Breast Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology; D002555:Cerebrospinal Fluid / Q000166:cytology; D005260:Female; D006801:Humans; D007278:Injections, Spinal; D008577:Meningeal Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000556:secondary; D008727:Methotrexate / Q000008:administration & dosage* / Q000009:adverse effects; D008875:Middle Aged; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis
D000964:Antimetabolites, Antineoplastic; D008727:Methotrexate