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A retrospective case series of 103 consecutive patients with leptomeningeal metastasis and breast cancer

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Abstract

Approximately 2–5 % of patients with breast cancer (BC) develop leptomeningeal metastasis (LM). 103 consecutive patients with BC were diagnosed with LM and initially treated with intra-CSF liposomal cytarabine from 2007 to 2011 at a single institution. Correlations were determined with respect to patient characteristics and BC subtype with regard to overall survival (OS). At LM diagnosis, 61 % of patients had a 0–2 performance status (PS), the remaining 39 % were severely neurologically impaired. Regardless of PS, all patients received intra-cerebrospinal fluid (CSF) liposomal cytarabine as first-line treatment. Systemic treatment and radiotherapy were also given in 58 and 17 % of patients respectively as clinically appropriate. Second- (intra-CSF thiotepa) and third-line (intra-CSF methotrexate) treatment was administered in 24 and 6 patients respectively. Median OS was 3.8 months (range 1 day–2.8 years). In multivariate analysis, an initial combined treatment, a second-line treatment with intra-CSF thiotepa, an initial clinical response, and a non-‘ER/PR/HER2 negative’ BC were significantly associated with a better OS. Median OS in this heterogeneous retrospective case series was similar to that of previously observed BC patients treated with intra-CSF methotrexate suggesting intra-CSF liposomal cytarabine is a reasonable first choice therapy of BC-related LM.

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Acknowledgments

Martine Roussel (nurse)

Conflict of interest

Dr Le Rhun and Dr Taillibert are currently conducting research sponsored by by Mundipharma and declare consultancies with Mundipharma. All remaining authors have declared no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Medical Oncology, Oscar Lambret Center, 3 rue Frédéric Combemale, 59020, Lille Cedex, France

    E. Le Rhun

  2. Department of Neurooncology, University Hospital Lille, Lille, France

    E. Le Rhun

  3. Department of Radiation Oncology, Pitié-Salpétrière Hospital, Paris, France

    S. Taillibert

  4. Department of Neuro-oncology, Pitié-Salpétrière Hospital, Paris, France

    S. Taillibert

  5. Department of Neurosurgery, University Hospital Lille, Lille, France

    F. Zairi

  6. Department of Medical Oncology, Oscar Lambret Center, Lille, France

    N. Kotecki, A. Mailliez, V. Servent, L. Vanlemmens & P. Vennin

  7. Department of Biostatistics, University Hospital Lille, Lille, France

    P. Devos

  8. Department of Biostatistics, University of Lille Nord de France, Lille, France

    P. Devos

  9. Department of Radiology, Oscar Lambret Center, Lille, France

    T. Boulanger

  10. Department of Pathology, Oscar Lambret Center, Lille, France

    M. C. Baranzelli & C. André

  11. Department of Clinical Pharmacy, Oscar Lambret Center, Lille, France

    G. Marliot & J. L. Cazin

  12. Department of Clinical Pharmacy, University of Lille Nord de France, Lille, France

    J. L. Cazin

  13. Department of Neurooncology, University Hospital Lille, Lille, France

    F. Dubois

  14. Department of Neurosurgery, University Hospital Lille, Lille, France

    R. Assaker

  15. Department of Neurosurgery, University of Lille Nord de France, Lille, France

    R. Assaker

  16. Department of Medical Oncology, Oscar Lambret Center, Lille, France

    J. Bonneterre

  17. Department of Medical Oncology, University of Lille Nord de France, Lille, France

    J. Bonneterre

  18. Department of Neurology, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA, USA

    M. C. Chamberlain

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  1. E. Le Rhun
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  18. M. C. Chamberlain
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Correspondence to E. Le Rhun.

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Le Rhun, E., Taillibert, S., Zairi, F. et al. A retrospective case series of 103 consecutive patients with leptomeningeal metastasis and breast cancer. J Neurooncol 113, 83–92 (2013). https://doi.org/10.1007/s11060-013-1092-8

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  • DOI: https://doi.org/10.1007/s11060-013-1092-8

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