Leptomeningeal disease: current diagnostic and therapeutic strategies.

Published online

Journal Article (Review)

Leptomeningeal disease has become increasingly prevalent as novel therapeutic interventions extend the survival of cancer patients. Although a majority of leptomeningeal spread occurs secondary to breast cancer, lung cancer, and melanoma, a wide variety of malignancies have been reported as primary sources. Symptoms on presentation are equally diverse, often involving a combination of neurological deficits with the possibility of obstructive hydrocephalus. Diagnosis is definitively made via cerebrospinal fluid cytology for malignant cells, but neuro-imaging with high quality T1-weighted magnetic resonance imaging can aid diagnosis and localization. While leptomeningeal disease is still a terminal, late-stage complication, a variety of treatment modalities, such as intrathecal chemotherapeutics and radiation therapy, have improved median survival from 4-6 weeks to 3-6 months. Positive prognosticative factors for survival include younger age, high performance scores, and controlled systemic disease. In looking to the future, diagnostics that improve early detection and chemotherapeutics tailored to the primary malignancy will likely be the most significant advances in improving survival.

Full Text

Duke Authors

Cited Authors

  • Nayar, G; Ejikeme, T; Chongsathidkiet, P; Elsamadicy, AA; Blackwell, KL; Clarke, JM; Lad, SP; Fecci, PE

Published Date

  • 2017-09-22

Published In

Volume / Issue

  • 8 / 42

Start / End Page

  • 73312 - 73328

PubMed ID

  • 29069871

Pubmed Central ID

  • 29069871

Electronic International Standard Serial Number (EISSN)

  • 1949-2553

Digital Object Identifier (DOI)

  • 10.18632/oncotarget.20272

Language

  • eng

Conference Location

  • United States