Journal of Neuro-Oncology

, Volume 84, Issue 1, pp 57–62 | Cite as

Breast cancer leptomeningeal metastasis—the role of multimodality treatment

  • Halina Rudnicka
  • Anna Niwińska
  • Magdalena Murawska
Original Paper

Abstract

Aim

The aim of the study was to assess the efficacy of multimodality treatment of patients with Leptomeningeal metastasis (LM) and to establish which method of treatment has the greatest positive impact on survival.

Material and Methods

Clinical material included 67 consecutive breast cancer patients with LM treated at the Cancer Center in Warsaw between the years 2000 and 2005. Intrathecal chemotherapy was given to 57 pts (85%), intravenous chemotherapy to 41 pts (61%), whole brain radiotherapy to 33 pts (49%) and radiotherapy to the spinal leptomeninges to 10 (15%). For 27 pts (40%) three methods of treatment were used. Univariate and multivariate analyses were used to evaluate the impact of the particular method of treatment on survival and to assess the efficacy of combined modalities.

Results

Clinical response was achieved in 49 pts (76%). Median survival calculated from the diagnosis of LM was 16 weeks (range 1–402 weeks). Univariate analysis showed positive impact of systemic intravenous chemotherapy (P = 0,0009), intrathecal chemotherapy (P = 0,008) and whole brain radiotherapy (P = 0,004) on survival. The results of Cox multivariate analysis have shown systemic chemotherapy (P < 0.001) and intrathecal chemotherapy (P = 0.001) to be significant.

Conclusions

Intravenous chemotherapy and, independently, intrathecal chemotherapy improve survival in breast cancer patients with LM. Radiotherapy has a positive impact on the quality of life due to the alleviation of neurological symptoms. The role of radiotherapy in prolonging survival is questionable.

Keywords

Breast cancer Carcinomatous meningitis Chemotherapy Intrathecal therapy Leptomeningeal metastases Radiotherapy 

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Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Halina Rudnicka
    • 1
  • Anna Niwińska
    • 1
  • Magdalena Murawska
    • 2
  1. 1.Department of Breast CancerMaria Sklodowska Curie Memorial Cancer Center and Institute of OncologyWarsawPoland
  2. 2.Department of BiostatisticsMaria Sklodowska Curie Memorial Cancer Center and Institute of OncologyWarsawPoland

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