title: Intrathecal Methotrexate and Craniospinal Radiotherapy Can Be an Effective Treatment of Carcinomatous Meningitis in Patients with Breast Cancer: Case Reports.
abstract: BACKGROUND
  Carcinomatous meningitis in breast cancer occurs as a complication in up to 5% of all cases. It is a very devastating diagnosis, with a median patient survival of about 3 months. Treatment is very controversial, and different modalities of treatment have been used but none of them show significant benefit for overall survival.
  
  
  METHODS
  We report 2 cases of carcinomatous meningitis in breast cancer patients. They received a similar treatment of a combination of intrathecal (IT) methotrexate followed by craniospinal radiotherapy. Both patients survived for many years after treatment and are in complete clinical and radiological remission.
  
  
  CONCLUSIONS
  Meningeal metastasis from breast cancer can be very effectively treated with IT and/or systemic chemotherapy followed by craniospinal radiotherapy. Further studies are needed to determine the effectiveness of this sequential combination of chemotherapy with radiotherapy.
authors.affiliation: Institute of Medical Genetics, Cardiff University, Cardiff, UK.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Meissner
authors.affiliation: Bristol Cancer Institute, University Hospitals Bristol Foundation NHS Trust, Bristol, UK.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Addeo
keywords: Breast cancer; Carcinomatous meningitis; Craniospinal radiotherapy; Intrathecal methotrexate; Leptomeningeal carcinoma; Meningeal carcinomatosis