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Practice Guideline
. 2023 Oct;8(5):101624.
doi: 10.1016/j.esmoop.2023.101624. Epub 2023 Sep 19.

Leptomeningeal metastasis from solid tumours: EANO-ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up

E Le Rhun  1 , M Weller  2 , M van den Bent  3 , D Brandsma  4 , J Furtner  5 , R Rudà  6 , D Schadendorf  7 , J Seoane  8 , J-C Tonn  9 , P Wesseling  10 , W Wick  11 , G Minniti  12 , S Peters  13 , G Curigliano  14 , M Preusser  15 ; EANO Guidelines Committee and ESMO Guidelines Committee. Electronic address: clinicalguidelines@esmo.org
Affiliations
Practice Guideline

Leptomeningeal metastasis from solid tumours: EANO-ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up

E Le Rhun et al. ESMO Open. 2023 Oct.

Abstract

  1. •

    This Clinical Practice Guideline provides recommendations for managing leptomeningeal metastases from solid tumours.

  2. •

    The guideline covers clinical, imaging and cytological diagnosis, staging and risk assessment, treatment and follow-up.

  3. •

    A treatment and management algorithm is provided.

  4. •

    The author panel encompasses a multidisciplinary group of experts from different institutions and countries in Europe.

  5. •

    Recommendations are based on available scientific data and the authors’ collective expert opinion.

Keywords: central nervous system; cerebral; cerebrospinal fluid; clinical practice guideline; neurological; recommendations.

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Figures

Figure 1
Figure 1
Treatment algorithm for the management of patients with LM. Intrathecal therapy: Intrathecal therapy should be considered in the presence of tumour cells in the CSF or in the presence of linear LM. Systemic pharmacotherapy: A modification of systemic therapy should always be discussed in case of progressive brain metastases or progressive extra-CNS disease. RT: Progressive brain metastases or progressive extra-CNS disease should be considered when selecting the choice of RT technique (in case of progressive brain metastases amenable to SRT, SRT should be preferred; in case of progressive brain metastases not amenable to SRT or in case of progressive extra-CNS disease without effective options for systemic treatment, WBRT can be considered). +, recommended; (+), can be considered; –, not recommended. CNS, central nervous system; CSF, cerebrospinal fluid; IT, intrathecal; LM, leptomeningeal metastasis; MRI, magnetic resonance imaging; RT, radiotherapy; SRT, stereotactic radiotherapy; VP, ventriculoperitoneal; WBRT, whole brain radiotherapy.aIf no CSF obstruction and no indication for a VP shunt without ON/OFF valve.
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References

    1. Le Rhun E., Weller M., Brandsma D., et al. EANO-ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up of patients with leptomeningeal metastasis from solid tumours. Ann Oncol. 2017;28(suppl 4):iv84–iv99. - PubMed
    1. Le Rhun E., Guckenberger M., Smits M., et al. EANO-ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up of patients with brain metastasis from solid tumours. Ann Oncol. 2021;32(11):1332–1347. - PubMed
    1. de Azevedo C.R.A.S., Cruz M.R.S., Chinen L.T.D., et al. Meningeal carcinomatosis in breast cancer: prognostic factors and outcome. J Neurooncol. 2011;104(2):565–572. - PubMed
    1. Lara-Medina F., Crismatt A., Villarreal-Garza C., et al. Clinical features and prognostic factors in patients with carcinomatous meningitis secondary to breast cancer. Breast J. 2012;18(3):233–241. - PubMed
    1. Meattini I., Livi L., Saieva C., et al. Prognostic factors and clinical features in patients with leptominengeal metastases from breast cancer: a single center experience. J Chemother. 2012;24(5):279–284. - PubMed

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