دورية أكاديمية
أعرض في EDS

Early Detection of Leptomeningeal Metastases Among Patients Undergoing Spinal Stereotactic Radiosurgery

التفاصيل البيبلوغرافية
العنوان: Early Detection of Leptomeningeal Metastases Among Patients Undergoing Spinal Stereotactic Radiosurgery
المؤلفون: Morgan E. Freret, MD, PhD, N. Ari Wijetunga, MD, PhD, Achraf A. Shamseddine, MD, PhD, Daniel S. Higginson, MD, Adam M. Schmitt, MD, Yoshiya Yamada, MD, Eric Lis, MD, Adrienne Boire, MD, PhD, Jonathan T. Yang, MD, PhD, Amy J. Xu, MD, PhD
المصدر: Advances in Radiation Oncology, Vol 8, Iss 2, Pp 101154- (2023)
بيانات النشر: Elsevier, 2023.
سنة النشر: 2023
المجموعة: LCC:Medical physics. Medical radiology. Nuclear medicine
LCC:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
مصطلحات موضوعية: Medical physics. Medical radiology. Nuclear medicine, R895-920, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
الوصف: Purpose: The management of patients with advanced solid malignancies increasingly uses stereotactic body radiation therapy (SBRT). Advanced cancer patients are at risk for developing leptomeningeal metastasis (LM), a fatal complication of metastatic cancer. Cerebrospinal fluid (CSF) is routinely collected during computed tomography (CT) myelography for spinal SBRT planning, offering an opportunity for early LM detection by CSF cytology in the absence of radiographic LM or LM symptoms (subclinical LM). This study tested the hypothesis that early detection of tumor cells in CSF in patients undergoing spine SBRT portends a similarly poor prognosis compared with clinically overt LM. Methods and Materials: We retrospectively analyzed clinical records for 495 patients with metastatic solid tumors who underwent CT myelography for spinal SBRT planning at a single institution from 2014 to 2019. Results: Among patients planned for SBRT, 51 (10.3%) developed LM. Eight patients (1.6%) had subclinical LM. Median survival with LM was similar between patients with subclinical versus clinically evident LM (3.6 vs 3.0 months, P = .30). Patients harboring both parenchymal brain metastases and LM (29/51) demonstrated shorter survival than those with LM alone (2.4 vs 7.1 months, P = .02). Conclusions: LM remains a fatal complication of metastatic cancer. Subclinical LM detected by CSF cytology in spine SBRT patients has a similarly poor prognosis compared with standardly detected LM and warrants consideration of central nervous system-directed therapies. As aggressive local therapies are increasingly used for metastatic patients, more sensitive CSF evaluation may further identify patients with subclinical LM and should be evaluated prospectively.
نوع الوثيقة: article
وصف الملف: electronic resource
اللغة: English
تدمد: 2452-1094
Relation: http://www.sciencedirect.com/science/article/pii/S2452109422002603; https://doaj.org/toc/2452-1094
DOI: 10.1016/j.adro.2022.101154
URL الوصول: https://doaj.org/article/32495e3cb1c94b41991951965c03b5b8
رقم الأكسشن: edsdoj.32495e3cb1c94b41991951965c03b5b8
قاعدة البيانات: Directory of Open Access Journals
الوصف
تدمد:24521094
DOI:10.1016/j.adro.2022.101154