Clinical improvement and survival in breast cancer leptomeningeal metastasis correlate with the cytologic response to intrathecal chemotherapy

Clinical improvement and survival in breast cancer leptomeningeal metastasis correlate with the cytologic response to intrathecal chemotherapy
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DOI:
10.1007/s11060-009-9940-2
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发表时间:
2009-12-01
影响因子:
3.9
通讯作者:
Blot, Emmanuel
Blot, Emmanuel
中科院分区:
医学2区
文献类型:
--
作者:
Clatot, Florian;Philippin-Lauridant, Geraldine;Blot, Emmanuel

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约5%的转移性乳腺癌发生轻脑膜脑膜炎,对于这种并发症尚无标准治疗方法。我们回顾性分析24例高剂量鞘内甲氨蝶呤治疗乳腺癌轻脑膜脑膜炎(BLM)的临床资料和脑脊液。11例患者(46%)观察到细胞学反应(治疗后脑脊液细胞学无肿瘤细胞),并与生存率相关(P = 0.005)。此外,11例有细胞学反应的患者和7例无细胞学反应的患者(54%)的临床症状均有改善(P = 0.02)。细胞学反应的预测价值有待进一步证实。细胞学反应可能有助于BLM患者鞘内化疗的管理。
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.