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. 2023 Nov 27:24:100331.
doi: 10.1016/j.lansea.2023.100331. eCollection 2024 May.

Treatment pattern and outcomes of leptomeningeal carcinomatosis in India - a retrospective study

Gautam Goyal  1   2 , Ashish Singh  3   2 , Manuprasad Avaronnan  4   2 , Nirmal Vivek Raut  5   2 , Vikas Talreja  6   2 , Arun Chandrasekharan  7   2 , Kushal Gupta  8   2 , Bharat Bhosale  9   2 , Rushabh Kiran Kothari  10   2 , Deevyashali Parekh  11 , Bhavesh Pradip Poladia  12   2 , Joydeep Ghosh  13   2 , Avinash Talele  14   2 , Sameer Shrirangwar  15   2 , Akshay Karpe  16   2
Affiliations

Treatment pattern and outcomes of leptomeningeal carcinomatosis in India - a retrospective study

Gautam Goyal et al. Lancet Reg Health Southeast Asia. .

Abstract

Background: Leptomeningeal carcinomatosis (LMC), the metastatic spread of cancer to the leptomeninges, is a rare complication and has a dismal prognosis. Due to limited data available on LMC from India, we conducted a country-wise audit of LMC across 15 centres in India.

Methods: The current study conducted in 2020, was a retrospective, multicentric audit of adult patients (aged ≥18 years) with diagnosis of LMC and who received treatment during 2010-2020. Baseline characteristics, details related to previous treatments, cancer sites, LMC diagnosis, treatment pattern and overall survival (OS) were collected. Descriptive statistics were performed, and Kaplan Meier analysis was performed for the estimation of OS.

Findings: Among the patients diagnosed with LMC (n = 84), diagnosis was confirmed in 52 patients (61.9%) and 'probable' in 32 (38.1%) patients. The three most common cause of malignancy were non-small cell lung cancer (NSCLC), breast cancer and gastrointestinal cancer with 45 (53.6%), 22 (26.1%) and 9 (10.7%) patients respectively. Intrathecal therapy was offered in 33 patients (39.3%). The most common intrathecal agent was methotrexate in 23 patients (27.4%). The median OS was 90 days (95% CI 48-128). Among tested variables, intrathecal therapy administration (hazard ratio [HR] = 0.36, 95% CI 0.19-0.68) and primary in lung (HR = 0.43, 95% CI 0.23-0.83) had a favourable impact on OS.

Interpretation: Prognosis with leptomeningeal carcinomatosis is poor with a significant burden of morbidity and mortality in India. This data aims to highlight the current outcomes and facilitate further research on LMC.

Funding: None.

Keywords: Intrathecal; LMIC; Leptomeningeal carcinomatosis; Outcomes; Pattern of care.

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Conflict of interest statement

Authors declare no conflicts of interest.

Figures

Fig. 1
Fig. 1
STROBE flowchart for this study.
Fig. 2
Fig. 2
Overall survival curve.
See this image and copyright information in PMC

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