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Leptomeningeal disease: current diagnostic and therapeutic strategies.

Publication ,  Journal Article
Nayar, G; Ejikeme, T; Chongsathidkiet, P; Elsamadicy, AA; Blackwell, KL; Clarke, JM; Lad, SP; Fecci, PE
Published in: Oncotarget
September 22, 2017

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.

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Published In

Oncotarget

DOI

EISSN

1949-2553

Publication Date

September 22, 2017

Volume

8

Issue

42

Start / End Page

73312 / 73328

Location

United States

Related Subject Headings

  • 3211 Oncology and carcinogenesis
  • 1112 Oncology and Carcinogenesis
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Nayar, G., Ejikeme, T., Chongsathidkiet, P., Elsamadicy, A. A., Blackwell, K. L., Clarke, J. M., … Fecci, P. E. (2017). Leptomeningeal disease: current diagnostic and therapeutic strategies. Oncotarget, 8(42), 73312–73328. https://doi.org/10.18632/oncotarget.20272
Nayar, Gautam, Tiffany Ejikeme, Pakawat Chongsathidkiet, Aladine A. Elsamadicy, Kimberly L. Blackwell, Jeffrey M. Clarke, Shivanand P. Lad, and Peter E. Fecci. “Leptomeningeal disease: current diagnostic and therapeutic strategies.Oncotarget 8, no. 42 (September 22, 2017): 73312–28. https://doi.org/10.18632/oncotarget.20272.
Nayar G, Ejikeme T, Chongsathidkiet P, Elsamadicy AA, Blackwell KL, Clarke JM, et al. Leptomeningeal disease: current diagnostic and therapeutic strategies. Oncotarget. 2017 Sep 22;8(42):73312–28.
Nayar, Gautam, et al. “Leptomeningeal disease: current diagnostic and therapeutic strategies.Oncotarget, vol. 8, no. 42, Sept. 2017, pp. 73312–28. Pubmed, doi:10.18632/oncotarget.20272.
Nayar G, Ejikeme T, Chongsathidkiet P, Elsamadicy AA, Blackwell KL, Clarke JM, Lad SP, Fecci PE. Leptomeningeal disease: current diagnostic and therapeutic strategies. Oncotarget. 2017 Sep 22;8(42):73312–73328.

Published In

Oncotarget

DOI

EISSN

1949-2553

Publication Date

September 22, 2017

Volume

8

Issue

42

Start / End Page

73312 / 73328

Location

United States

Related Subject Headings

  • 3211 Oncology and carcinogenesis
  • 1112 Oncology and Carcinogenesis