{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T04:49:22Z","timestamp":1778906962135,"version":"3.51.4"},"reference-count":46,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2016,6,30]],"date-time":"2016-06-30T00:00:00Z","timestamp":1467244800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Intl Journal of Cancer"],"published-print":{"date-parts":[[2016,10,15]]},"abstract":"<jats:p>The prognosis of leptomeningeal metastasis (LM) from solid tumors is extremely poor, especially for patients with adverse prognostic factors. In this phase II clinical trial, we evaluated the efficacy and safety of intrathecal chemotherapy (IC) combined with concomitant involved\u2010field radiotherapy (IF\u2010RT) for treating LM from solid tumors with adverse prognostic factors. Fifty\u2010nine patients with LM from various solid tumors were enrolled between May 2010 and December 2014. Concurrent therapy consisted of concomitant IC (methotrexate 12.5\u201315 mg and dexamethasone 5 mg, weekly) and IF\u2010RT (whole brain and\/or spinal canal RT, 40 Gy\/20f). For patients with low Karnofsky performance status (KPS) score and radiotherapy intolerance, induction IC (1\u20133 times) was given before concurrent therapy. Thirty\u2010eight patients (64.4%) received subsequent treatments. All patients were followed up at least 6 months after LM diagnosis or until death. Primary endpoint evaluated was clinical response rate. Secondary endpoints were overall survival (OS) and safety. The pathological types included lung cancer (<jats:italic>n<\/jats:italic>\u2009=\u200942), breast cancer (<jats:italic>n<\/jats:italic>\u2009=\u200911) and others (<jats:italic>n<\/jats:italic>\u2009=\u20096). Median KPS score was 40 (range 20\u201370). Fifty\u2010one patients (86.4%) completed concurrent therapy. The overall response rate was 86.4% (51\/59). OS ranged from 0.4 to 36.7 months (median 6.5 months), and 1\u2010year\u2010survival rate was 21.3%. Treatment\u2010related adverse events mainly included acute meningitis, chronic\u2010delayed encephalopathy, radiculitis, myelosuppression and mucositis. Twelve patients (20.3%) had grade III\u2013V toxic reactions. We concluded that IC combined with concomitant IF\u2010RT, with significant efficacy and acceptable toxicity, may be an optimal therapeutic option for treatment of LM from solid tumors with adverse prognostic factors. LM, in which cancer cells spread to membranes enveloping the brain and spinal cord, is a devastating complication of solid cancers. Existing LM therapies center on IC. In this prospective clinical study, the authors combined intrathecal methotrexate with involved\u2010field radiotherapy in a concomitant regimen, showing that the approach can potentially improve quality of life for patients with adverse prognostic factors. Concurrent radiotherapy\u2010bolstered IC by contributing to prolonged remission of neurological symptoms and increasing OS. The findings suggest that the concomitant regimen could be an optimal treatment option for LM.<\/jats:p>","DOI":"10.1002\/ijc.30214","type":"journal-article","created":{"date-parts":[[2016,5,31]],"date-time":"2016-05-31T15:52:47Z","timestamp":1464709967000},"page":"1864-1872","source":"Crossref","is-referenced-by-count":106,"title":["Concurrent radiotherapy and intrathecal methotrexate for treating leptomeningeal metastasis from solid tumors with adverse prognostic factors: A prospective and single\u2010arm study"],"prefix":"10.1002","volume":"139","author":[{"given":"Zhenyu","family":"Pan","sequence":"first","affiliation":[{"name":"Department of Radiation\u2010Oncology The First Hospital of Jilin University Changchun 130021 China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guozi","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Radiation\u2010Oncology The First Hospital of Jilin University Changchun 130021 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