Document Detail


Neoplastic meningitis from solid tumors: new diagnostic and therapeutic approaches.
MedLine Citation:
PMID:  21795431     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Neoplastic meningitis is a result of the spread of malignant cells to the leptomeninges and subarachnoid space and their dissemination within the cerebrospinal fluid. This event occurs in 4%-15% of all patients with solid tumors and represents an important prognostic factor for poor survival. Neoplastic meningitis should be diagnosed in the early stages of disease to prevent important neurological deficits and to provide the most appropriate treatment. Despite new diagnostic approaches developed in recent years, such as positron emission tomography-computed tomography and new biological markers, the combination of magnetic resonance imaging without and with gadolinium enhancement and cytology still has the greatest diagnostic sensitivity. Recently, no new randomized studies comparing intrathecal (i.t.) with systemic treatment have been performed, yet there have been a few small phase II studies and case reports about new molecularly targeted substances whose successful i.t. or systemic application has been reported. Trastuzumab, gefitinib, and sorafenib are examples of possible future treatments for neoplastic meningitis, in order to better individualize therapy thus allowing better outcomes. In this review, we analyze the most recent and interesting developments on diagnostic and therapeutic approaches.
Authors:
Giuseppe Lombardi; Fable Zustovich; Patrizia Farina; Alessandro Della Puppa; Renzo Manara; Diego Cecchin; Antonella Brunello; Alessandro Cappetta; Vittorina Zagonel
Publication Detail:
Type:  Journal Article; Review     Date:  2011-07-27
Journal Detail:
Title:  The oncologist     Volume:  16     ISSN:  1549-490X     ISO Abbreviation:  Oncologist     Publication Date:  2011  
Date Detail:
Created Date:  2011-08-29     Completed Date:  2012-02-01     Revised Date:  2012-04-25    
Medline Journal Info:
Nlm Unique ID:  9607837     Medline TA:  Oncologist     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1175-88     Citation Subset:  IM    
Affiliation:
Medical Oncology 1 Unit, Istituto Oncologico Veneto–IRCCS, Padova, Italy. giuseppe.lombardi@ioveneto.it
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MeSH Terms
Descriptor/Qualifier:
Antineoplastic Agents / therapeutic use
Clinical Trials as Topic
Humans
Meningitis / diagnosis*,  drug therapy*,  etiology,  radiotherapy
Neoplasm Metastasis
Neoplasms / cerebrospinal fluid,  complications*
Subarachnoid Space / pathology
Chemical
Reg. No./Substance:
0/Antineoplastic Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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