{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T04:56:16Z","timestamp":1790571376342,"version":"4.1.0"},"reference-count":44,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate clinical outcomes and identify prognostic determinants in patients with lung cancer leptomeningeal metastasis (LCLM) treated with Ommaya reservoir-based intrathecal (IT) chemotherapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>We retrospectively reviewed 154 LCLM patients treated at Fudan University Shanghai Cancer Center (2022-2025). All patients underwent Ommaya reservoir implantation, or combined with VP shunt. IT pemetrexed (30 mg\/week) was delivered for 4\u20136 consecutive weeks. Clinical characteristics, cerebrospinal fluid (CSF) and magnetic resonance imaging (MRI) features were collected. Survival outcomes were assessed using Kaplan\u2013Meier and Cox regression analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The cohort had a median age of 59 years (IQR, 53-65) with predominance of female sex (59.1%), lung adenocarcinoma (98.1%), and EGFR mutations (76.7%). Median overall survival (OS) for the entire cohort was 331 days (IQR, 266\u2013446). To provide guidance on clinical decision making, we established an exploratory four-tier prognostic system integrating KPS and intracranial pressure (ICP), categorizing patients into distinct prognostic quartiles. Our analysis revealed that among patients with Karnofsky Performance Status (KPS) \u226570, a normal ICP was associated with superior survival. Conversely, in patients with KPS \u2264 50, a decrease in intracranial pressure indicates a poorer prognosis for the patients. Multivariate Cox regression identified KPS, extracranial metastasis, MRI morphology, and CSF glucose\/protein as independent prognostic factors. A nomogram developed from these variables showed excellent discrimination (AUC\u00a0=\u00a00.894) and robust calibration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study establishes a practical risk stratification system and a prognostic nomogram to assist individualized clinical decision-making for LCLM patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1915711","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T04:29:03Z","timestamp":1790569743000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical outcomes and prognostic factors of Ommaya reservoir-based intrathecal chemotherapy in lung cancer leptomeningeal metastasis: a retrospective cohort 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China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhe","family":"Qi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Fudan University Shanghai Cancer Center","place":["Shanghai, China"]},{"name":"Department of Oncology, Shanghai Medical College, Fudan University","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bihani","family":"Pokharel","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Fudan University Shanghai Cancer Center","place":["Shanghai, China"]},{"name":"Department of Oncology, Shanghai Medical College, Fudan University","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lushao","family":"Zhang","sequence":"additional","affiliation":[{"name":"Shanghai Medical College, Fudan University","place":["Shanghai, 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