caa a22 4500 606215611 CHVBK 20210128101059.0 cr unu---uuuuu 210128e20150401xx s 000 0 eng 10.1007/s00701-015-2344-5 doi (NATIONALLICENCE)springer-10.1007/s00701-015-2344-5 Optimal treatment of leptomeningeal spread in glioblastoma: analysis of risk factors and outcome [Elektronische Daten] [Jung-Hoon Noh, Min Lee, Won Kim, Do Lim, Sung Kim, Doo-Sik Kong, Do-Hyun Nam, Jung-Il Lee, Ho Seol] Background: Glioblastoma (GBM) is the most common and malignant brain tumor in adults. Despite therapeutic advances, almost all patients eventually experience tumor recurrence. Leptomeningeal spread (LMS) is not a rare condition of recurrence. However, the standard management protocol of LMS has not been established. The aim of this study is to report the risk of (LMS) and the prognosis between treatment modalities in GBM patients. Methods: A retrospective review was conducted of 321 patients who were diagnosed with GBM between January 2006 and December 2010. In 75 patients, LMS of tumor was detected by magnetic resonance image and/or cerebrospinal fluid cytology. Twelve patients underwent intrathecal methotrexate (IT-MTX) chemotherapy. Twenty-two patients underwent other salvage treatments. Forty-one patients underwent conservative management. We analyzed the possible clinical factors for LMS. Further, we examined overall survival and survival after diagnosis of LMS for several treatment modalities. Results: In patients without LMS, median overall survival was 479days, whereas that in patients with LMS it was 401days. Younger age and larger initial tumor size were related to more frequent LMS incidence. Proximity between tumor margin and ventricle did not affect LMS. However, median duration from initial diagnosis to LMS was significantly different according to the distance to the ventricle. IT-MTX group's overall survival was 583days, which is statistically no longer than that of the other treatment group and the conservative management group. However, an additional survival benefit may exist compared to the conservative treatment. The median survival of the IT-MTX group was 181days compared with 91days for the conservative management group. Conclusions: Treatment of LMS is mainly palliative. IT-MTX is generally the first-line treatment modality of LMS. Prediction and prevention of LMS is crucial because its treatment has been limited. Further approaches to improve the therapeutic effect should be established. Springer-Verlag Wien, 2015 Glioblastoma nationallicence Leptomeningeal spread nationallicence Risk factor nationallicence Intrathecal chemotherapy nationallicence Noh Jung-Hoon Department of Neurosurgery, Samsung Medical Centre, Sungkyunkwan University School of Medicine, 81 Irwon-ro, 135-710, Seoul, Gangnam-gu, Korea aut Lee Min Department of Neurosurgery, Samsung Medical Centre, Sungkyunkwan University School of Medicine, 81 Irwon-ro, 135-710, Seoul, Gangnam-gu, Korea aut Kim Won Division of Hematology-Oncology, Department of Medicine, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea aut Lim Do Department of Radiation Oncology, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea aut Kim Sung Department of Radiology, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea aut Kong Doo-Sik Department of Neurosurgery, Samsung Medical Centre, Sungkyunkwan University School of Medicine, 81 Irwon-ro, 135-710, Seoul, Gangnam-gu, Korea aut Nam Do-Hyun Department of Neurosurgery, Samsung Medical Centre, Sungkyunkwan University School of Medicine, 81 Irwon-ro, 135-710, Seoul, Gangnam-gu, Korea aut Lee Jung-Il Department of Neurosurgery, Samsung Medical Centre, Sungkyunkwan University School of Medicine, 81 Irwon-ro, 135-710, Seoul, Gangnam-gu, Korea aut Seol Ho Department of Neurosurgery, Samsung Medical Centre, Sungkyunkwan University School of Medicine, 81 Irwon-ro, 135-710, Seoul, Gangnam-gu, Korea aut Acta Neurochirurgica Springer Vienna 157/4(2015-04-01), 569-576 0001-6268 157:4<569 2015 157 701 https://doi.org/10.1007/s00701-015-2344-5 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00701-015-2344-5 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Noh Jung-Hoon Department of Neurosurgery, Samsung Medical Centre, Sungkyunkwan University School of Medicine, 81 Irwon-ro, 135-710, Seoul, Gangnam-gu, Korea aut NATIONALLICENCE 700 1- Lee Min Department of Neurosurgery, Samsung Medical Centre, Sungkyunkwan University School of Medicine, 81 Irwon-ro, 135-710, Seoul, Gangnam-gu, Korea aut NATIONALLICENCE 700 1- Kim Won Division of Hematology-Oncology, Department of Medicine, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea aut NATIONALLICENCE 700 1- Lim Do Department of Radiation Oncology, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea aut NATIONALLICENCE 700 1- Kim Sung Department of Radiology, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea aut NATIONALLICENCE 700 1- Kong Doo-Sik Department of Neurosurgery, Samsung Medical Centre, Sungkyunkwan University School of Medicine, 81 Irwon-ro, 135-710, Seoul, Gangnam-gu, Korea aut NATIONALLICENCE 700 1- Nam Do-Hyun Department of Neurosurgery, Samsung Medical Centre, Sungkyunkwan University School of Medicine, 81 Irwon-ro, 135-710, Seoul, Gangnam-gu, Korea aut NATIONALLICENCE 700 1- Lee Jung-Il Department of Neurosurgery, Samsung Medical Centre, Sungkyunkwan University School of Medicine, 81 Irwon-ro, 135-710, Seoul, Gangnam-gu, Korea aut NATIONALLICENCE 700 1- Seol Ho Department of Neurosurgery, Samsung Medical Centre, Sungkyunkwan University School of Medicine, 81 Irwon-ro, 135-710, Seoul, Gangnam-gu, Korea aut NATIONALLICENCE 773 0- Acta Neurochirurgica Springer Vienna 157/4(2015-04-01), 569-576 0001-6268 157:4<569 2015 157 701