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1. Jacob E, Scorsone K, Blaney SM, D'Argenio DZ, Berg SL: Synergy of karenitecin and mafosfamide in pediatric leukemia, medulloblastoma, and neuroblastoma cell lines. Pediatr Blood Cancer; 2008 Apr;50(4):757-60
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  • BACKGROUND: A major barrier to treatment of leptomeningeal disease is the lack of proven combination chemotherapy regimens for intrathecal administration.
  • PROCEDURE: A modified methyl tetrazolium (MTT) assay was used to determine the sensitivity of the cells to karenitecin and mafosfamide.
  • Cells were exposed to drug for 72 hr, after which the number of surviving cells was quantitated.
  • For drug combination experiments, cells were exposed to medium alone (controls), single drugs alone (mafosfamide only, karenitecin only) or to different concentrations of the combination of the two drugs (karenitecin + mafosfamide), for a total of 36 concentration pairs per plate.
  • For both drugs nearly complete inhibition of cell growth was demonstrated at higher concentrations in all cell lines.
  • In the D283 medulloblastoma and both the leukemia cell lines (JM1 and Molt-4), the drug interaction was additive.
  • CONCLUSIONS: Karenitecin and mafosfamide are additive or synergistic in vitro against tumor types that disseminate to the leptomeninges.

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  • [Copyright] (c) 2008 Wiley-Liss, Inc.
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  • (PMID = 17849472.001).
  • [ISSN] 1545-5017
  • [Journal-full-title] Pediatric blood & cancer
  • [ISO-abbreviation] Pediatr Blood Cancer
  • [Language] ENG
  • [Grant] United States / NIBIB NIH HHS / EB / P41 EB001978; United States / NIBIB NIH HHS / EB / P41-EB001978; United States / NIBIB NIH HHS / EB / P41 EB001978-245377; United States / NCI NIH HHS / CA / K12 CA090433; United States / NIBIB NIH HHS / EB / P41 EB001978-24; United States / NIBIB NIH HHS / EB / EB001978-245377; United States / NINR NIH HHS / NR / 1K23NR9192-01; United States / NCI NIH HHS / CA / 5K12CA90433; United States / NINR NIH HHS / NR / K23 NR009192
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural
  • [Publication-country] United States
  • [Chemical-registry-number] 24R60NVC41 / cositecan; 5970HH9923 / mafosfamide; 8N3DW7272P / Cyclophosphamide; XT3Z54Z28A / Camptothecin
  • [Other-IDs] NLM/ NIHMS233694; NLM/ PMC2975705
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2. Bergman I, Barmada MA, Griffin JA, Slamon DJ: Treatment of meningeal breast cancer xenografts in the rat using an anti-p185/HER2 antibody. Clin Cancer Res; 2001 Jul;7(7):2050-6
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  • [Title] Treatment of meningeal breast cancer xenografts in the rat using an anti-p185/HER2 antibody.
  • The metastatic spread of breast cancer to the leptomeninges (LM) is a painful, debilitating, and usually lethal condition.
  • Current therapies are generally ineffective or extremely toxic.
  • The current study evaluated monoclonal antibody therapy in an animal model of LM human breast cancer.
  • Treatment with 4D5 did not result in outgrowth of cells lacking expression of the HER2/neu receptor.
  • [MeSH-major] Antibodies, Monoclonal / pharmacology. Breast Neoplasms / drug therapy. Meningeal Neoplasms / drug therapy. Receptor, ErbB-2 / immunology
  • [MeSH-minor] Animals. Brain / drug effects. Brain / immunology. Brain / pathology. Cell Division / drug effects. Dose-Response Relationship, Drug. Female. Humans. Immunohistochemistry. Injections, Intraventricular. Neoplasm Transplantation. Rats. Rats, Nude. Tumor Cells, Cultured. Xenograft Model Antitumor Assays

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  • (PMID = 11448923.001).
  • [ISSN] 1078-0432
  • [Journal-full-title] Clinical cancer research : an official journal of the American Association for Cancer Research
  • [ISO-abbreviation] Clin. Cancer Res.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; EC 2.7.10.1 / Receptor, ErbB-2
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3. Shinno K, Nagahiro S, Uno M, Kannuki S, Nakaiso M, Sano N, Horiguchi H: Neurocutaneous melanosis associated with malignant leptomeningeal melanoma in an adult: clinical significance of 5-S-cysteinyldopa in the cerebrospinal fluid---case report. Neurol Med Chir (Tokyo); 2003 Dec;43(12):619-25
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  • [Title] Neurocutaneous melanosis associated with malignant leptomeningeal melanoma in an adult: clinical significance of 5-S-cysteinyldopa in the cerebrospinal fluid---case report.
  • A 35-year-old male presented with a variant of neurocutaneous melanosis with leptomeningeal malignant melanoma.
  • Ventriculoperitoneal shunting was performed and extensive pigmented leptomeninges were recognized.
  • Open biopsy established the diagnosis of leptomeningeal malignant melanoma.
  • The 5-S-CD level decreased after each treatment, but the basal level steadily increased prior to the next treatment.
  • Two years after the onset, he showed paraplegia caused by an extramedullary mass at the T-6 level.
  • He underwent emergent removal of the spinal tumor and showed transient marked improvement.
  • Further intensive chemotherapy was given.
  • However, he died 31 months after the onset of massive proliferation of intracranial leptomeningeal melanoma.
  • Measurement of CSF 5-S-CD levels is valuable for evaluating the therapeutic efficacy and for monitoring the progression of melanoma.
  • [MeSH-major] Cysteinyldopa / cerebrospinal fluid. Melanoma / cerebrospinal fluid. Melanoma / complications. Melanosis / complications. Meningeal Neoplasms / cerebrospinal fluid. Meningeal Neoplasms / complications. Neurocutaneous Syndromes / complications

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  • (PMID = 14723271.001).
  • [ISSN] 0470-8105
  • [Journal-full-title] Neurologia medico-chirurgica
  • [ISO-abbreviation] Neurol. Med. Chir. (Tokyo)
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 19641-92-0 / Cysteinyldopa
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4. Cruz-Munoz W, Man S, Xu P, Kerbel RS: Development of a preclinical model of spontaneous human melanoma central nervous system metastasis. Cancer Res; 2008 Jun 15;68(12):4500-5
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  • Preclinical testing of novel therapeutic approaches would be aided by the development of appropriate models of spontaneous CNS metastasis arising from primary tumors.
  • A highly metastatic variant of the WM239A human melanoma cell line, designated 113/6-4L, was generated and used to test the efficacy of long-term, low-dose metronomic cyclophosphamide and vinblastine chemotherapy on advanced established metastatic disease in sites such as liver, lungs, and lymph node.
  • This treatment resulted in control of advanced, systemic disease and prolongation of survival.
  • Two cell lines (131/4-5B1 and 131/4-5B2) were generated from such metastases, which were found to spontaneously metastasize to brain parenchyma with occasional localization to leptomeninges, after orthotopic transplantation and removal of the primary tumor.
  • These findings represent the first report of spontaneous CNS metastases generated from primary tumors of any human cancer in mice, which heritably maintains this phenotype, and as such, the variant cell lines generated should aid studies in the biology and treatment of CNS metastases, especially of melanoma origin.
  • [MeSH-major] Brain Neoplasms / secondary. Disease Models, Animal. Liver Neoplasms / secondary. Lung Neoplasms / secondary. Melanoma / secondary. Skin Neoplasms / pathology
  • [MeSH-minor] Animals. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Cell Adhesion / drug effects. Cell Adhesion / physiology. Cell Proliferation / drug effects. Culture Media, Conditioned / pharmacology. Cyclophosphamide / administration & dosage. Female. Lymphatic Metastasis. Mice. Mice, Nude. Mice, SCID. Survival Rate. Vinblastine / administration & dosage. Xenograft Model Antitumor Assays

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  • [CommentIn] Cancer Res. 2009 Jan 15;69(2):719; author reply 720 [19147591.001]
  • (PMID = 18559492.001).
  • [ISSN] 1538-7445
  • [Journal-full-title] Cancer research
  • [ISO-abbreviation] Cancer Res.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA-41233
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Culture Media, Conditioned; 5V9KLZ54CY / Vinblastine; 8N3DW7272P / Cyclophosphamide
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5. Kochi M, Itoyama Y, Shiraishi S, Kitamura I, Marubayashi T, Ushio Y: Successful treatment of intracranial nongerminomatous malignant germ cell tumors by administering neoadjuvant chemotherapy and radiotherapy before excision of residual tumors. J Neurosurg; 2003 Jul;99(1):106-14
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  • [Title] Successful treatment of intracranial nongerminomatous malignant germ cell tumors by administering neoadjuvant chemotherapy and radiotherapy before excision of residual tumors.
  • OBJECT: The goal of this study was to confirm the effectiveness of our novel treatment strategy, neoadjuvant therapy (NAT) consisting of combined chemo- and radiotherapy, which are performed before complete excision of residual tumor in patients with intracranial nongerminomatous malignant germ cell tumors (NGMGCTs).
  • METHODS: The authors treated 11 consecutive patients with NGMGCTs by applying NAT consisting of combined platinum-based chemotherapy and radiotherapy, followed by complete excision of residual tumors.
  • The pretreatment diagnosis, based on tumor markers with or without biopsy, was yolk sac tumor in five patients, embryonal carcinoma in one patient, immature teratoma in one patient, and mixed germ cell tumor containing malignant tumor components in four patients.
  • In one patient a leptomeningeal tumor recurred and he died of the disease 21 months after diagnosis.
  • CONCLUSIONS: Neoadjuvant therapy, consisting of combined chemo- and radiotherapy, followed by complete excision of residual tumors is highly effective in patients with intracranial NGMGCTs.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Brain Neoplasms. Carcinoma. Endodermal Sinus Tumor. Germinoma. Neoadjuvant Therapy / methods. Neoplasms, Germ Cell and Embryonal
  • [MeSH-minor] Adolescent. Adult. Biomarkers, Tumor. Biopsy. Child. Combined Modality Therapy. Disease Progression. Drug Administration Schedule. Female. Humans. Magnetic Resonance Imaging. Male. Neoplasm, Residual / pathology. Neoplasm, Residual / surgery. Postoperative Care. Quality of Life. Treatment Outcome

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  • (PMID = 12854751.001).
  • [ISSN] 0022-3085
  • [Journal-full-title] Journal of neurosurgery
  • [ISO-abbreviation] J. Neurosurg.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor
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6. Massimino M, Gandola L, Spreafico F, Biassoni V, Luksch R, Collini P, Solero CN, Simonetti F, Pignoli E, Cefalo G, Poggi G, Modena P, Mariani L, Potepan P, Podda M, Casanova M, Pecori E, Acerno S, Ferrari A, Terenziani M, Meazza C, Polastri D, Ravagnani F, Fossati-Bellani F: No salvage using high-dose chemotherapy plus/minus reirradiation for relapsing previously irradiated medulloblastoma. Int J Radiat Oncol Biol Phys; 2009 Apr 1;73(5):1358-63
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  • [Title] No salvage using high-dose chemotherapy plus/minus reirradiation for relapsing previously irradiated medulloblastoma.
  • PURPOSE: Myeloablative regimens were frequently used for medulloblastoma relapsing after craniospinal irradiation (CSI): in 1997-2002, we used repeated surgery, standard-dose and myeloablative chemotherapy, and reirradiation.
  • Hematopoietic precursor mobilization followed high-dose etoposide or high-dose cyclophosphamide or cisplatin/etoposide therapy.
  • After the overall chemotherapy program, reirradiation was prescribed when possible.
  • RESULTS: Seventeen patients were treated: previous treatment included CSI of 19.5-36 Gy with posterior fossa/tumor boost and chemotherapy in 16 patients.
  • Relapse sites included leptomeninges in 9 patients, spine in 4 patients, posterior fossa in 3 patients, and brain in 1 patient.
  • Twelve of 14 patients with assessable tumor had an objective response after reinduction; 2 experienced progression and were not given the myeloablative courses.
  • Additional relapses appeared in 13 patients continuing the treatment.
  • CONCLUSIONS: Despite responses being obtained and ample use of surgery and reirradiation, second-line therapy with myeloablative schedules was not curative, barring a few exceptions.
  • A salvage therapy for medulloblastoma after CSI still needs to be sought.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Cerebellar Neoplasms. Medulloblastoma. Neoplasm Recurrence, Local. Salvage Therapy
  • [MeSH-minor] Adolescent. Carboplatin / administration & dosage. Carboplatin / adverse effects. Child. Child, Preschool. Cisplatin / administration & dosage. Cisplatin / adverse effects. Combined Modality Therapy / methods. Cyclophosphamide / administration & dosage. Cyclophosphamide / adverse effects. Disease-Free Survival. Drug Administration Schedule. Etoposide / administration & dosage. Etoposide / adverse effects. Female. Granulocyte Colony-Stimulating Factor / administration & dosage. Humans. Male. Methotrexate / administration & dosage. Methotrexate / adverse effects. Radiotherapy Dosage. Remission Induction / methods. Thiotepa / administration & dosage. Thiotepa / adverse effects. Vincristine / administration & dosage. Vincristine / adverse effects. Young Adult

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  • (PMID = 19019566.001).
  • [ISSN] 1879-355X
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 143011-72-7 / Granulocyte Colony-Stimulating Factor; 5J49Q6B70F / Vincristine; 6PLQ3CP4P3 / Etoposide; 8N3DW7272P / Cyclophosphamide; 905Z5W3GKH / Thiotepa; BG3F62OND5 / Carboplatin; Q20Q21Q62J / Cisplatin; YL5FZ2Y5U1 / Methotrexate
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7. Aiello-Laws L, Rutledge DN: Management of adult patients receiving intraventricular chemotherapy for the treatment of leptomeningeal metastasis. Clin J Oncol Nurs; 2008 Jun;12(3):429-35
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  • [Title] Management of adult patients receiving intraventricular chemotherapy for the treatment of leptomeningeal metastasis.
  • Cancer in the central nervous system can arise from a primary brain tumor and metastasize to the brain or to the leptomeninges, leading to leptomeningeal metastasis (LM).
  • LM also is called leptomeningeal carcinomatosis and carcinomatous meningitis.
  • Nursing care of patients with LM requires an understanding of neurologic anatomy and physiology, along with associated treatments and complications.
  • Treatment of LM may involve intrathecal or, more likely, intraventricular chemotherapy.
  • The purpose of this article is to review the literature, summarize clinical care recommendations, and construct evidence-based guidelines for the administration of intraventricular chemotherapy and the care and monitoring of patients with LM.
  • [MeSH-major] Antimetabolites, Antineoplastic / therapeutic use. Cytarabine / therapeutic use. Injections, Intraventricular / nursing. Meningeal Neoplasms / drug therapy. Oncology Nursing / organization & administration
  • [MeSH-minor] Acquired Immunodeficiency Syndrome / complications. Adult. Blepharoptosis / etiology. Brain Neoplasms / pathology. Carcinoma / drug therapy. Carcinoma / nursing. Carcinoma / secondary. Drug Compounding. Drug Monitoring / nursing. Evidence-Based Medicine. Fatal Outcome. Humans. Low Back Pain / etiology. Lymphoma, AIDS-Related / complications. Male. Muscle Weakness / etiology. Nurse's Role. Nursing Assessment. Practice Guidelines as Topic

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  • (PMID = 18515241.001).
  • [ISSN] 1092-1095
  • [Journal-full-title] Clinical journal of oncology nursing
  • [ISO-abbreviation] Clin J Oncol Nurs
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antimetabolites, Antineoplastic; 04079A1RDZ / Cytarabine
  • [Number-of-references] 30
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8. Ochiai H, Moore SA, Archer GE, Okamura T, Chewning TA, Marks JR, Sampson JH, Gromeier M: Treatment of intracerebral neoplasia and neoplastic meningitis with regional delivery of oncolytic recombinant poliovirus. Clin Cancer Res; 2004 Jul 15;10(14):4831-8
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  • [Title] Treatment of intracerebral neoplasia and neoplastic meningitis with regional delivery of oncolytic recombinant poliovirus.
  • PURPOSE: Spread to the central nervous system (CNS) and the leptomeninges is a frequent complication of systemic cancers that is associated with serious morbidity and high mortality.
  • We have evaluated a novel therapeutic approach against CNS complications of breast cancer based on the human neuropathogen poliovirus (PV).
  • We evaluated CD155 expression in several human breast tumor tissue specimens and cultured breast cancer cell lines.
  • RESULTS: We observed that breast cancer tissues and cell lines derived thereof express CD155 at levels mediating exquisite sensitivity toward PV-induced oncolysis in the latter.
  • This assumption was confirmed in xenotransplantation models for neoplastic meningitis or solitary cerebral metastasis, where local virus treatment dramatically improved survival.
  • CONCLUSIONS: Our findings suggest oncolytic PV recombinants as a viable treatment option for CNS complications of breast cancer.

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  • (PMID = 15269159.001).
  • [ISSN] 1078-0432
  • [Journal-full-title] Clinical cancer research : an official journal of the American Association for Cancer Research
  • [ISO-abbreviation] Clin. Cancer Res.
  • [Language] ENG
  • [Grant] United States / NCI NIH HHS / CA / R01 CA087537; United States / NCI NIH HHS / CA / CA87537
  • [Publication-type] Comparative Study; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / DNA, Recombinant; 0 / Membrane Proteins; 0 / Receptors, Virus; 0 / poliovirus receptor
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9. Kerr JZ, Berg S, Blaney SM: Intrathecal chemotherapy. Crit Rev Oncol Hematol; 2001 Mar;37(3):227-36
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  • [Title] Intrathecal chemotherapy.
  • An unforeseen consequence of improved disease-free survival in many hematologic and solid tumor malignancies has been an increase in the incidence of disease recurrence in the leptomeninges.
  • The recognition of the central nervous system (CNS) as a unique 'sanctuary' site has resulted in the development of therapeutic strategies specifically directed at the leptomeninges.
  • Although therapeutic strategies have been successful in the prevention and treatment of CNS leukemia, there are still a paucity of therapeutic options for patients with neoplastic meningitis due to solid tumors or recurrent CNS leukemia.
  • This article provides an overview of the pharmacology and toxicity of intrathecal agents that are commonly employed in the treatment and prevention of leptomeningeal disease, and describes new agents that are in the early stages of clinical development.
  • [MeSH-major] Antineoplastic Agents / administration & dosage. Meninges / pathology. Neoplasms / drug therapy. Neoplasms / pathology
  • [MeSH-minor] Humans. Injections, Spinal. Leukemic Infiltration / prevention & control. Meningeal Neoplasms / prevention & control

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  • (PMID = 11248578.001).
  • [ISSN] 1040-8428
  • [Journal-full-title] Critical reviews in oncology/hematology
  • [ISO-abbreviation] Crit. Rev. Oncol. Hematol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Ireland
  • [Chemical-registry-number] 0 / Antineoplastic Agents
  • [Number-of-references] 56
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10. Vélayoudom FL, Cardot-Bauters C, Decouvelaere AV, Vlaeminck V, Bauters F, Wémeau JL: Non Hodgkin's lymphoma involving the adrenal glands and the central nervous system (CNS): a particular evolution after chemotherapy. Ann Endocrinol (Paris); 2005 Dec;66(6):527-31
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  • [Title] Non Hodgkin's lymphoma involving the adrenal glands and the central nervous system (CNS): a particular evolution after chemotherapy.
  • After aggressive polychemotherapy and methotrexate intrathecal injection, a dissociated therapeutic response was observed with a decrease of the cerebral lesion and an increase of the adrenal mass.
  • This result may be explained by the efficacy of corticosteroid therapy on cerebral edema.
  • The prognosis was poor with tumor infiltration of the leptomeninges and death 16 months after diagnosis.
  • [MeSH-major] Adrenal Gland Neoplasms / drug therapy. Central Nervous System Neoplasms / drug therapy. Lymphoma, Non-Hodgkin / drug therapy
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Biopsy, Needle. Fatal Outcome. Humans. Magnetic Resonance Imaging. Male. Middle Aged. Tomography, X-Ray Computed

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  • (PMID = 16357815.001).
  • [ISSN] 0003-4266
  • [Journal-full-title] Annales d'endocrinologie
  • [ISO-abbreviation] Ann. Endocrinol. (Paris)
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] France
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11. Jaeckle KA: Improving the outcome of patients with leptomeningeal cancer: new clinical trials and experimental therapies. Cancer Treat Res; 2005;125:181-93
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  • [Title] Improving the outcome of patients with leptomeningeal cancer: new clinical trials and experimental therapies.
  • Current therapy for leptomeningeal metastases is predominantly palliative.
  • In an effort to improve disease control and patient outcome, new strategies are being developed to target the cerebrospinal space.
  • These include new intrathecal formulations of systemic chemotherapy as well as the development of radiolabeled immunoconjugates and antitumor antibodies.
  • Furthermore, there is debate as to the optimal strategy of drug delivery for leptomeningeal tumor.
  • [MeSH-major] Meningeal Neoplasms / drug therapy
  • [MeSH-minor] Antineoplastic Agents / administration & dosage. Antineoplastic Agents / therapeutic use. Clinical Trials as Topic / methods. Clinical Trials as Topic / trends. Humans. Injections, Spinal. Treatment Outcome

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  • (PMID = 16211890.001).
  • [ISSN] 0927-3042
  • [Journal-full-title] Cancer treatment and research
  • [ISO-abbreviation] Cancer Treat. Res.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents
  • [Number-of-references] 50
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12. Watanabe Y, Hotta T, Yoshioka H, Itou Y, Taniyama K, Sugiyama K: Primary diffuse leptomeningeal gliosarcomatosis. J Neurooncol; 2008 Jan;86(2):207-10

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Primary diffuse leptomeningeal gliosarcomatosis.
  • We report a 48-year-old woman with primary diffuse leptomeningeal gliomatosis (PDLG) histologically diagnosed as gliosarcoma.
  • Computerized tomography (CT) scans showed ventricular dilatation consistent with communicating hydrocephalus.
  • As no diagnosis could be made she underwent biopsy of the leptomeninges.
  • Despite chemotherapy and radiotherapy she died 11 months after admission.
  • Autopsy findings included gliosarcoma in the leptomeninges and spinal cord without an underlying parenchymal tumor.
  • To our knowledge, this is the first report of primary diffuse leptomeningeal gliosarcomatosis.
  • [MeSH-major] Gliosarcoma / pathology. Meningeal Neoplasms / pathology. Neoplasms, Neuroepithelial / pathology. Spinal Cord Neoplasms / pathology

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  • (PMID = 17628746.001).
  • [ISSN] 0167-594X
  • [Journal-full-title] Journal of neuro-oncology
  • [ISO-abbreviation] J. Neurooncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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13. Drappatz J, Batchelor TT: Leptomeningeal neoplasms. Curr Treat Options Neurol; 2007 Jul;9(4):283-93
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Leptomeningeal neoplasms.
  • Leptomeningeal metastasis is becoming an increasingly important late complication of cancer as survival from systemic disease increases, and due to the fact that many novel cancer drugs fail to achieve therapeutic concentrations in the central nervous system.
  • Definitive diagnosis is established by the demonstration of malignant cells in the CSF.
  • However, in certain circumstances the presence of leptomeningeal enhancement on brain or spinal MRI may be sufficient to make the diagnosis.
  • Early diagnosis and aggressive treatment may delay neurologic progression and can lead to prolonged survival and improvement of neurologic function in certain patients.
  • The prognosis depends on the underlying malignancy but is often poor, with a median survival of 4 months, and most treatment interventions are palliative.
  • Nevertheless, some patients respond to treatment, and some survive beyond 1 or 2 years after diagnosis.
  • Areas of radiographic bulky disease or symptomatic tumor should receive radiotherapy.
  • Intrathecal chemotherapy is most effective in patients with lymphoma, leukemia, or breast cancer and without evidence of bulky disease on neuroimaging.
  • Intrathecal chemotherapy requires normal CSF flow, and the most commonly used agents are methotrexate, cytarabine, and thiotepa.
  • In lieu of intrathecal therapy, systemic chemotherapy may occasionally be indicated in select patients in part based on its ability to penetrate into bulky disease.
  • There is hope that progress in diagnostic modalities and the development of more effective intrathecal antineoplastic drugs may decrease neurologic morbidity and improve quality of life and survival.

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  • (PMID = 17580008.001).
  • [ISSN] 1092-8480
  • [Journal-full-title] Current treatment options in neurology
  • [ISO-abbreviation] Curr Treat Options Neurol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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14. Schultz CJ, Bovi J: Current management of primary central nervous system lymphoma. Int J Radiat Oncol Biol Phys; 2010 Mar 1;76(3):666-78
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Primary central nervous cell lymphoma (PCNSL) is an uncommon neoplasm of the brain, leptomeninges, and rarely the spinal cord.
  • A whole-brain radiation volume has empirically been used to adequately address the multifocal tumor frequently encountered at the time of PCNSL diagnosis.
  • Chemotherapy alone or in combination with WBRT has more recently become the treatment of choice.
  • High response rates and improved survival with the use of chemotherapy has led to treatment strategies that defer or eliminate WBRT in hopes of lessening the risk of neurotoxicity attributed to WBRT.
  • Combined chemotherapy and WBRT regimens are now being explored that use lower total doses of radiation and altered fractionation schedules with the aim of maintaining high rates of tumor control while minimizing neurotoxicity.
  • Pretreatment, multifactor prognostic indices have recently been described that may allow selection of treatment regimens that strike an appropriate balance of risk and benefit for the individual PCNSL patient.
  • [MeSH-major] Central Nervous System Neoplasms / therapy. Lymphoma / therapy
  • [MeSH-minor] Antineoplastic Agents / therapeutic use. Combined Modality Therapy / methods. Cranial Irradiation / adverse effects. Diagnostic Imaging / methods. Humans. Immunocompetence. Lymphoma, AIDS-Related / therapy. Prognosis. Radiotherapy Planning, Computer-Assisted / methods

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  • [Copyright] Copyright (c) 2010 Elsevier Inc. All rights reserved.
  • (PMID = 20159361.001).
  • [ISSN] 1879-355X
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents
  • [Number-of-references] 72
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15. Begemann M, Lyden D, Rosenblum MK, Lis E, Wolden S, Antunes NL, Dunkel IJ: Primary leptomeningeal primitive neuroectodermal tumor. J Neurooncol; 2003 Jul;63(3):299-303
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Primary leptomeningeal primitive neuroectodermal tumor.
  • Leptomeningeal metastases are a common complication of medulloblastomas and other primitive neuroectodermal tumors (PNETs).
  • Much rarer are PNETs apparently arising in the leptomeninges.
  • An 8-year-old boy presented with headache and vomiting, due to neoplastic meningitis from primary neuroectodermal tumor without an identifying mass.
  • After craniospinal irradiation and chemotherapy (carboplatin, vincristine, cyclophosphamide and lomustine) the boy was in remission for 14 months, then suffered several relapses despite various chemotherapy regimens.
  • After the initial presentation of 3.5 years the boy began to suffer from prolonged refractory non-convulsive status epilepticus and later expired from progression of primary leptomeningeal PNET.
  • [MeSH-major] Meningeal Neoplasms / pathology. Neuroectodermal Tumors, Primitive / pathology
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carboplatin / administration & dosage. Child. Combined Modality Therapy. Cranial Irradiation. Cyclophosphamide / administration & dosage. Fatal Outcome. Humans. Lomustine / administration & dosage. Magnetic Resonance Imaging. Male. Radiotherapy Dosage. Remission Induction. Vincristine / administration & dosage

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  • (PMID = 12892237.001).
  • [ISSN] 0167-594X
  • [Journal-full-title] Journal of neuro-oncology
  • [ISO-abbreviation] J. Neurooncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Netherlands
  • [Chemical-registry-number] 5J49Q6B70F / Vincristine; 7BRF0Z81KG / Lomustine; 8N3DW7272P / Cyclophosphamide; BG3F62OND5 / Carboplatin
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16. Lee O, Cromwell LD, Weider DJ: Carcinomatous meningitis arising from primary nasopharyngeal carcinoma. Am J Otolaryngol; 2005 May-Jun;26(3):193-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Carcinomatous meningitis, also known as leptomeningeal metastasis and meningeal carcinomatosis, is the invasion of neoplastic cells into the leptomeninges.
  • The patient was subsequently diagnosed with nasopharyngeal carcinoma by biopsy and treated with radiation as well as chemotherapy.
  • In 1993, magnetic resonance imaging scan of the head revealed recurrence of nasopharyngeal carcinoma with involvement of the ethmoid sinuses as well as extension of the tumor into the frontotemporal leptomeninges.
  • We also review the literature with respect to the diagnosis and treatment of carcinomatosis meningitis.
  • [MeSH-major] Meningeal Neoplasms / etiology. Meningeal Neoplasms / secondary. Nasopharyngeal Neoplasms / pathology

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  • (PMID = 15858776.001).
  • [ISSN] 0196-0709
  • [Journal-full-title] American journal of otolaryngology
  • [ISO-abbreviation] Am J Otolaryngol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Radioisotopes; AU0V1LM3JT / Gadolinium
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17. Wang CJ, Wang CY: Nasopharyngeal carcinoma with leptomeningeal dissemination: case report. Chang Gung Med J; 2000 Feb;23(2):118-22
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Nasopharyngeal carcinoma with leptomeningeal dissemination: case report.
  • Spread of this tumor is known to occur via three main routes, i.e., local invasion of adjacent structures, regional metastasis to neck nodes, and hematogenous metastasis to distant organs.
  • In this report, we describe a rare case of NPC disseminated via the leptomeninges, so called meningeal carcinomatosis (MC).
  • The primary tumor regressed completely after induction chemotherapy and radiation therapy.
  • Computerized tomography (CT) 17 months after radiation therapy showed multiple enhanced nodules scattered along the temporal meninges.
  • The patient declined further invasive procedures and oncologic treatments, and he expired at home 9 months after the development of MC.
  • The case, although rare, possibly highlights a rare route of tumor dissemination in NPC.
  • [MeSH-major] Carcinoma, Squamous Cell / secondary. Meningeal Neoplasms / secondary. Nasopharyngeal Neoplasms / pathology

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  • (PMID = 10835808.001).
  • [ISSN] 2072-0939
  • [Journal-full-title] Chang Gung medical journal
  • [ISO-abbreviation] Chang Gung Med J
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] China (Republic : 1949- )
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18. Lekovic GP, Gonzalez LF, Shetter AG, Porter RW, Smith KA, Brachman D, Spetzler RF: Role of Gamma Knife surgery in the management of pineal region tumors. Neurosurg Focus; 2007;23(6):E12
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • OBJECT: Increasingly, radiosurgery is used to treat pineal region tumors, either as a primary treatment or as an adjunct to conventional radiation therapy.
  • The authors report their experience with Gamma Knife surgery (GKS) for the treatment of pineal region tumors.
  • All patients were treated using Leksell Gamma Plan treatment planning software (versions 4.12::5.34).
  • The mean treatment volume was 7.42 cm(3) (range 1.2-32.5 cm(3)).
  • Prescribed doses ranged from 12 to 18 Gy.
  • In 2 of these 16 patients (one with an anaplastic astrocytoma, the other with a primitive neuroectodermal tumor), leptomeningeal and spinal spread of tumor developed despite control of the pineal lesions.
  • Conclusions Excellent control of pineal region brain tumors can be obtained with GKS when it is used in conjunction with surgery, conventional radiation therapy, or both.
  • Patient survival and quality of life can be optimized through the use of multimodal treatment, including surgery, conventional radiation therapy and/or radiosurgery, and chemotherapy, when applicable.
  • [MeSH-major] Brain Neoplasms / surgery. Pineal Gland / surgery. Pinealoma / surgery. Radiosurgery / methods

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  • (PMID = 18081477.001).
  • [ISSN] 1092-0684
  • [Journal-full-title] Neurosurgical focus
  • [ISO-abbreviation] Neurosurg Focus
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] United States
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19. Pels H, Schulz H, Manzke O, Hom E, Thall A, Engert A: Intraventricular and intravenous treatment of a patient with refractory primary CNS lymphoma using rituximab. J Neurooncol; 2002 Sep;59(3):213-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Intraventricular and intravenous treatment of a patient with refractory primary CNS lymphoma using rituximab.
  • The treatment of primary central nervous system lymphoma (PCNSL) with chemo- and radiotherapy is efficient in terms of tumor response.
  • However, time to tumor progression often is of short duration and leptomeningeal relapse is common.
  • After treatment with intravenous and intraventricular administration of the chimeric anti-CD20 monoclonal antibody rituximab, a total clearing of lymphoma cells in the cerebrospinal fluid (CSF) was achieved.
  • There was no change in the size of the parenchymal tumor mass but there was slight improvement of clinical symptoms after therapy.
  • Antibody levels in CSF were measured at 7 timepoints during and after the treatment period.
  • These data suggest that intraventicular treatment with rituximab is safe and feasible with a potential activity on leptomeningeal tumor manifestation.
  • [MeSH-major] Antibodies, Monoclonal / administration & dosage. Antineoplastic Agents / administration & dosage. Brain Neoplasms / drug therapy. Lymphoma, B-Cell / drug therapy
  • [MeSH-minor] Aged. Antibodies, Monoclonal, Murine-Derived. Antigens, CD20 / metabolism. Blood Circulation / immunology. Humans. Infusions, Intravenous. Injections, Intraventricular. Magnetic Resonance Imaging. Male. Neoplasm Recurrence, Local / drug therapy. Neoplasm Recurrence, Local / immunology. Remission Induction. Rituximab

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  • (PMID = 12241117.001).
  • [ISSN] 0167-594X
  • [Journal-full-title] Journal of neuro-oncology
  • [ISO-abbreviation] J. Neurooncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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20. Yomo S, Tada T, Hirayama S, Tachibana N, Otani M, Tanaka Y, Hongo K: A case report and review of the literature. J Neurooncol; 2007 Jan;81(2):209-16

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Primary diffuse leptomeningeal gliomatosis (PDLG) is a rare central nervous system neoplasm in which gliomatous tissue is diffusely identified in the subarachnoid space with no evidence of a primary intraparenchymal tumor.
  • Magnetic resonance (MR) imaging demonstrated diffuse leptomeningeal enhancement without any source of intraparenchymal lesion.
  • A biopsy disclosed wide spreading of anaplastic glial cells within the leptomeninges.
  • He died 3 months later because of disease progression despite both radiotherapy and chemotherapy.
  • [MeSH-major] Glioma / pathology. Meningeal Neoplasms / pathology

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  • (PMID = 17031563.001).
  • [ISSN] 0167-594X
  • [Journal-full-title] Journal of neuro-oncology
  • [ISO-abbreviation] J. Neurooncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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21. Vassilyadi M, Michaud J: Hydrocephalus as the initial presentation of a spinal cord astrocytoma associated with leptomeningeal spread. Pediatr Neurosurg; 2005 Jan-Feb;41(1):29-34
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  • [Title] Hydrocephalus as the initial presentation of a spinal cord astrocytoma associated with leptomeningeal spread.
  • CSF studies procured during the procedure were all normal.
  • Spine MRI showed diffuse leptomeningeal enhancement and a 1.5-cm intramedullary lesion at T12-L1 associated with minimal edema.
  • Chemotherapy was administered and follow-up spine MRI at 2 months did not reveal any residual tumor, however, the leptomeningeal enhancement persisted.
  • Sixteen months later, at the completion of the chemotherapy and radiation therapy, the spine MRI remained unchanged.
  • [MeSH-major] Astrocytoma / pathology. Hydrocephalus / etiology. Meningeal Neoplasms / complications. Meningeal Neoplasms / secondary. Neoplastic Cells, Circulating. Spinal Cord Neoplasms / pathology

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  • [Copyright] Copyright 2005 S. Karger AG, Basel.
  • (PMID = 15886510.001).
  • [ISSN] 1016-2291
  • [Journal-full-title] Pediatric neurosurgery
  • [ISO-abbreviation] Pediatr Neurosurg
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Switzerland
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22. Gilmer-Hill HS, Ellis WG, Imbesi SG, Boggan JE: Spinal oligodendroglioma with gliomatosis in a child. Case report. J Neurosurg; 2000 Jan;92(1 Suppl):109-13
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  • The authors present a rare case of oligodendrogliomatosis in a child, which they believe originated from a primary spinal cord tumor.
  • At 2.5 years of age this boy developed poor balance, neck stiffness, and a regression in developmental milestones.
  • A computerized tomography (CT) scan of the head initially revealed ventriculomegaly and multiple cystic cerebellar lesions.
  • A CT scan of the head and an MR image obtained 3 years later demonstrated diffuse small cysts on the surface of the brainstem, cerebellum, medial temporal and inferior frontal cortices, subcortical white matter, and corpus callosum suggestive of leptomeningeal tumor spread.
  • The cells appeared to migrate along the subpial space but no tumor cells were present in the subarachnoid space.
  • Despite having a complicated course, chemotherapy with carboplatin has provided the patient with long-term palliation and a high quality of life.
  • This case may represent the fifth report in the literature of oligodendrogliomatosis occurring in a child but only the third occurring with a spinal primary tumor.
  • [MeSH-major] Brain Neoplasms / pathology. Glioma / pathology. Neoplasms, Multiple Primary / pathology. Oligodendroglioma / pathology. Spinal Cord Neoplasms / pathology
  • [MeSH-minor] Child, Preschool. Combined Modality Therapy. Humans. Magnetic Resonance Imaging. Male. Palliative Care. Photomicrography. Tomography, X-Ray Computed


23. Strik H, Prömmel P: Diagnosis and individualized therapy of neoplastic meningitis. Expert Rev Anticancer Ther; 2010 Jul;10(7):1137-48
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Diagnosis and individualized therapy of neoplastic meningitis.
  • Neoplastic meningitis is a diffuse dissemination of tumor cells into the cerebrospinal fluid (CSF) and/or leptomeninges.
  • Treatment must be individually shaped: the CSF dissemination may be treated with intrathecal chemotherapy with methotrexate or cytarabinoside (Ara-C).
  • Systemic chemotherapy is needed to control solid manifestations or, in the case of substances entering the CSF, to support intrathecal chemotherapy.
  • [MeSH-minor] Adult. Antineoplastic Agents / administration & dosage. Antineoplastic Agents / pharmacokinetics. Antineoplastic Agents / therapeutic use. Cerebrospinal Fluid / cytology. Combined Modality Therapy. Cranial Irradiation. Cytarabine / administration & dosage. Cytarabine / therapeutic use. Diagnostic Imaging. Female. Humans. Injections, Spinal. Liposomes. Magnetic Resonance Imaging. Male. Middle Aged. Neoplasm Invasiveness. Nervous System Diseases / etiology

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  • (PMID = 20645702.001).
  • [ISSN] 1744-8328
  • [Journal-full-title] Expert review of anticancer therapy
  • [ISO-abbreviation] Expert Rev Anticancer Ther
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Liposomes; 04079A1RDZ / Cytarabine
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24. Shigekawa T, Takeuchi H, Misumi M, Matsuura K, Sano H, Fujiuchi N, Okubo K, Osaki A, Aogi K, Saeki T: Successful treatment of leptomeningeal metastases from breast cancer using the combination of trastuzumab and capecitabine: a case report. Breast Cancer; 2009;16(1):88-92
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  • [Title] Successful treatment of leptomeningeal metastases from breast cancer using the combination of trastuzumab and capecitabine: a case report.
  • We report a case of metastatic breast cancer with leptomeninges and multiple bone metastases that showed an excellent response to the combination of trastuzumab and capecitabine; therapeutic effect was evaluated by MRI at follow-up.
  • In April 2003, a tumor at the right basis cerebri and multiple bone metastases were noted, and in October 2003, she underwent enucleation of the tumor.
  • Histopathologically, the tumor was consistent with a basal skull metastasis from breast cancer.
  • She was diagnosed, with leptomeningeal metastasis (LM) from breast cancer using MRI.
  • In December 2005, the combination of trastuzumab and capecitabine administered as sixth-line treatment was very effective for LM.
  • Although it is generally very difficult to diagnose LM and assess the therapeutic effect with MRI, in this case, it was possible.
  • Although the mechanism underlying the efficacy of this combination is still unknown, the treatment would be worth trying because of its few side effects in extensively treated patients with LM from breast cancer.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Breast Neoplasms / pathology. Carcinoma, Ductal, Breast / secondary. Carcinoma, Ductal, Breast / therapy. Meningeal Neoplasms / drug therapy. Meningeal Neoplasms / secondary
  • [MeSH-minor] Adult. Antibodies, Monoclonal / administration & dosage. Antibodies, Monoclonal, Humanized. Antineoplastic Agents / administration & dosage. Bone Neoplasms / secondary. Bone Neoplasms / surgery. Capecitabine. Deoxycytidine / administration & dosage. Deoxycytidine / analogs & derivatives. Female. Fluorouracil / administration & dosage. Fluorouracil / analogs & derivatives. Humans. Mastectomy. Trastuzumab

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  • (PMID = 18478315.001).
  • [ISSN] 1880-4233
  • [Journal-full-title] Breast cancer (Tokyo, Japan)
  • [ISO-abbreviation] Breast Cancer
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / Antibodies, Monoclonal, Humanized; 0 / Antineoplastic Agents; 0W860991D6 / Deoxycytidine; 6804DJ8Z9U / Capecitabine; P188ANX8CK / Trastuzumab; U3P01618RT / Fluorouracil
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25. Mehta M, Bradley K: Radiation therapy for leptomeningeal cancer. Cancer Treat Res; 2005;125:147-58
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  • [Title] Radiation therapy for leptomeningeal cancer.
  • Radiotherapy has multiple roles in the treatment of leptomeningeal cancer.
  • While it is uncommon for patients to experience regression of neurologic deficits due to leptomeningeal cancer, focal radiotherapy often provides significant palliation of pain, increased intracranial pressure and other focal symptoms.
  • Focal radiotherapy may also be used to eliminate blockages of cerebrospinal fluid (CSF) and allow for safe administration of intrathecal chemotherapy.
  • Craniospinal irradiation (CSI) is most often used as prophylaxis for patients at high risk of leptomeningeal tumor dissemination, but may result in symptom palliation and prolonged disease control for patients with active leptomeningeal tumor.
  • [MeSH-major] Meningeal Neoplasms / physiopathology. Meningeal Neoplasms / radiotherapy. Pain

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  • (PMID = 16211888.001).
  • [ISSN] 0927-3042
  • [Journal-full-title] Cancer treatment and research
  • [ISO-abbreviation] Cancer Treat. Res.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 26
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26. Kobayashi H, Ishii N, Murata J, Saito H, Kubota KC, Nagashima K, Iwasaki Y: Cystic meningioangiomatosis. Pediatr Neurosurg; 2006;42(5):320-4
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  • A 14-year-old boy without any stigmata of neurofibromatosis type 2 presented intractable complex partial and generalized seizures since the age of 12 years.
  • The tumor was located in the leptomeninges and cerebral cortex.
  • The patient underwent surgical treatment because medical treatment with phenytoin and sodium valproate was not sufficient to control the seizures.
  • [MeSH-minor] Adolescent. Electroencephalography. Humans. Male. Seizures / drug therapy. Seizures / etiology. Seizures / surgery

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  • [Copyright] Copyright 2006 S. Karger AG, Basel.
  • (PMID = 16902347.001).
  • [ISSN] 1016-2291
  • [Journal-full-title] Pediatric neurosurgery
  • [ISO-abbreviation] Pediatr Neurosurg
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Switzerland
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27. Taillibert S, Laigle-Donadey F, Chodkiewicz C, Sanson M, Hoang-Xuan K, Delattre JY: Leptomeningeal metastases from solid malignancy: a review. J Neurooncol; 2005 Oct;75(1):85-99
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  • [Title] Leptomeningeal metastases from solid malignancy: a review.
  • Leptomeningeal metastases (LMM) consist of diffuse involvement of the leptomeninges by infiltrating cancer cells.
  • Cerebro-spinal fluid (CSF) analysis is almost always abnormal but only a positive cytology or demonstration of intrathecal synthesis of tumor markers is diagnostic.
  • T1-weighted gadolinium-enhanced sequence of the entire neuraxis (brain and spine) plays an important role in supporting the diagnosis, demonstrating the involved sites and guiding treatment.
  • Radionuclide CSF flow studies detect CSF compartmentalization and are useful for treatment planning.
  • Standard therapy relies mainly on focal irradiation and intrathecal or systemic chemotherapy.
  • Studies using other therapeutic approaches such as new biological or cytotoxic compounds are ongoing.
  • The overall prognosis remains grim and quality of life should remain the priority when deciding which treatment option to apply.
  • However, a sub-group of patients, tentatively defined here, may benefit from an aggressive treatment.
  • [MeSH-major] Breast Neoplasms / pathology. Lung Neoplasms / pathology. Meningeal Neoplasms / secondary

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  • (PMID = 16215819.001).
  • [ISSN] 0167-594X
  • [Journal-full-title] Journal of neuro-oncology
  • [ISO-abbreviation] J. Neurooncol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 182
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28. Rudnicka H, Niwińska A, Gruszfeld A, Pieńkowski T: [Diagnosis and treatment of carcinoid meningitis: a challenge to the neurologist and oncologist]. Neurol Neurochir Pol; 2003;37(4):811-24
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  • [Title] [Diagnosis and treatment of carcinoid meningitis: a challenge to the neurologist and oncologist].
  • [Transliterated title] Diagnostyka i leczenie nowotworowego zapalenia opon mózgowo-rdzeniowych wyzwaniem dla neurologa i onkologa.
  • BACKGROUND: Two clinical types of leptomeningeal metastases from solid tumors are observed: local and disseminated.
  • The former (meningeal carcinomatosis) consists in nodular infiltration of leptomeninges, while the latter (carcinomatous meningitis)--in tumor cells free floating in the cerebrospinal fluid and adhering as a monolayer to the surface of neural structures.
  • Despite the same etiology, the two types of metastasis differ in their clinical manifestation and prognosis.
  • Patients with local, nodular infiltration of leptomeninges may survive many years without symptoms of the disease.
  • On the other hand, carcinomatous meningitis, with its usually violent course and short survival, has become a major problem for oncologists and neurologists because of limited efficacy and considerable toxicity of the treatment.
  • AIMS: The purpose of this article is to review the current knowledge about carcinomatous meningitis in breast cancer patients, taking into account pathophysiology, clinical symptoms, diagnosis, treatment and prognosis.
  • The second aim was to present the authors' experience with the treatment of breast cancer patients suffering from carcinomatous meningitis.
  • In a majority of cases combined treatment was applied, including intrathecal administration of cytostatics, intravenous systemic chemotherapy and radiotherapy.
  • A response to the treatment was achieved in 76% of the patients.
  • Treatment results are disappointing, although the combined modality treatment appears to be the best option.
  • New pharmacological approaches to the treatment of meningeal malignancy are required to improve the outcome of patients with carcinomatous meningitis.
  • [MeSH-major] Breast Neoplasms / pathology. Carcinoma. Medical Oncology / methods. Meningeal Neoplasms. Neurology / methods

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  • (PMID = 14746241.001).
  • [ISSN] 0028-3843
  • [Journal-full-title] Neurologia i neurochirurgia polska
  • [ISO-abbreviation] Neurol. Neurochir. Pol.
  • [Language] pol
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Poland
  • [Number-of-references] 22
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29. Mizutani T: [Clinical aspects and pathogenesis of neurological complications due to malignant lymphomas]. Rinsho Shinkeigaku; 2002 Nov;42(11):1118-20
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • They include 1) infiltration and compression due to lymphoma itself, 2) ischemia due to intravascular proliferation of lymphoma cells, 3) paraneoplastic syndrome, 4) immunodeficiency due to lymphomas, 5) organ dysfunction due to lymphomatous infiltration, and 6) complication related to therapies against lymphomas.
  • The second patient was a 52-year-old man with lymphoma, who developed myelopathy caused by an intradural extramedullary spinal cord tumor.
  • He received chemotherapy and radiation therapy, followed by complete remission.
  • The third was a 80-year-old man with left cavernous sinus syndrome, which did not respond to therapies against lymphoma.
  • The fourth was a 55-year-old man who presented with numb chin syndrome on both sides, followed by multifocal lymphomatous involvement of the cranial nerves, spinal roots and leptomeninges.
  • Early diagnosis and treatment are essential for the better outcome of neurological complications due to lymphomas.

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  • (PMID = 12784681.001).
  • [ISSN] 0009-918X
  • [Journal-full-title] Rinshō shinkeigaku = Clinical neurology
  • [ISO-abbreviation] Rinsho Shinkeigaku
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article; Review
  • [Publication-country] Japan
  • [Number-of-references] 8
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30. Rogers LR: Cerebrovascular complications in cancer patients. Neurol Clin; 2003 Feb;21(1):167-92
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Cancer treatments may also contribute to this coagulopathy, which usually, but not exclusively, occurs in the setting of advanced malignant disease.
  • There is no established treatment for the thrombotic coagulopathy associated with cancer, but anticoagulation should be considered.
  • Therapy of acute DIC is controversial and should be individualized for the clinical setting.
  • Cerebrovascular disorders can complicate metastatic or primary tumor in the brain, skull, dura, or leptomeninges.
  • The clinical signs of infarction are indistinguishable from other causes of stroke, except that tumor-related venous occlusion will usually first produce signs of increased intracranial pressure.
  • The diagnosis of tumor-related infarction can usually be established by neuroimaging studies that show infarction and may show extracerebral sites of tumor.
  • CSF examination is useful in diagnosing leptomeningeal metastasis.
  • A search for lung or cardiac tumor should be performed when embolic tumor infarction is suspected.
  • Primary or metastatic tumors in the brain or dura may hemorrhage, producing the initial clinical signs of the brain tumor or a change in chronic signs induced by the tumor.
  • The brain hemorrhage may require evacuation and the underlying tumor will usually require additional antineoplastic treatment.
  • Cerebral arterial or venous thrombosis is sometimes the result of cancer therapy.
  • The attribution of thrombosis to chemotherapy in many published cases is only speculative, because carefully conducted prospective studies that include investigation for other thrombotic causes are not available.
  • The best-known associations with thrombosis are L-asparaginase, which is typically used in the induction therapy of acute lymphocytic leukemia, and combination hormonal therapy and chemotherapy for breast cancer.
  • Small clinical series suggest that surgical treatment is equally effective as in nonirradiated carotid atherosclerosis.
  • Brain hemorrhages can result from chemotherapy effects on the hemostatic system or a microangiopathic anemia.
  • Opportunistic infections, especially fungal infections, can complicate cancer or its treatment.
  • A clinician can usually establish the cause of stroke in the cancer patient by performing a careful review of the clinical setting--including the type and extent of cancer and the type of antineoplastic therapy--in which the stroke occurred.
  • Therapy may ameliorate symptoms or prevent further episodes.
  • [MeSH-major] Cerebrovascular Disorders / etiology. Neoplasms / complications

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  • (PMID = 12690649.001).
  • [ISSN] 0733-8619
  • [Journal-full-title] Neurologic clinics
  • [ISO-abbreviation] Neurol Clin
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 87
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