Outcome after whole brain radiotherapy alone in intracranial leptomeningeal carcinomatosis from solid tumors.
BACKGROUND
The purpose of the present study was to investigate outcome after whole brain radiotherapy (WBRT) alone as a palliative treatment without concomitant chemotherapy for intracranial leptomeningeal carcinomatosis (LMC).


METHODS
Overall survival and treatment response were retrospectively analyzed in 27 consecutive patients with LMC from breast and lung cancer. All patients had evidence of intracranial manifestations of LMC. Seven potential prognostic factors were evaluated.


RESULTS
Median overall survival (OS) for the entire group was 8.1 weeks. OS rates after 6 and 12 months were 26% and 15%, respectively. Improvement of neurological deficits was observed in 3 patients. In 3 of 4 patients with follow-up MRI studies, a decreased size of contrast-enhanced lesions was observed. Prognostic factors for improved OS on univariate analysis were absence of cranial nerve dysfunction, Karnofsky Performance Score (KPS) > 60%, and time interval > 35 months between the initial diagnosis of malignant disease and development of LMC. On multivariate analysis, absence of cranial nerve dysfunction remained the only significant prognosticator for OS (median 3.7 vs. 19.4 weeks, p < 0.001).


CONCLUSIONS
WBRT alone is an effective palliative treatment for patients unfit/unsuitable for chemotherapy and low performance status suffering from intracranial LMC. However, prognostic factors should be considered in order to identify patients who are likely to benefit from WBRT.
Department of Radiation Oncology, University of Tübingen, Hoppe-Seyler-Strasse 3, Tübingen, Germany.
C
C
Gani
A C
AC
Müller
F
F
Eckert
C
C
Schroeder
B
B
Bender
G
G
Pantazis
M
M
Bamberg
B
B
Berger
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000175:diagnosis / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D008297:Male; D055756:Meningeal Carcinomatosis / Q000532:radiotherapy*; D008875:Middle Aged; D010166:Palliative Care; D020266:Radiotherapy, Conformal / Q000379:methods*; D016896:Treatment Outcome