ABSTRACT
<p><b>OBJECTIVE</b>To investigate the clinical characteristics and prognostic factors of leptomeningeal metastases (LM) from solid tumors and to develop better treatment strategies.</p><p><b>METHODS</b>The clinical characteristics and follow-up results of 77 cases of leptomeningeal metastases (LM) from solid tumors diagnosed and treated in our hospital from 2002 to 2011 were retrospectively analyzed. Clinical characteristics, treatment methods and overall survival were analyzed using Kaplan-Meier method and Cox regression model.</p><p><b>RESULTS</b>The median survival time for all the patients was 88 days. KPS score, control of the primary tumor and systemic treatment were correlated with survival time for the patients (P < 0.05 for all). The median survival time of systemic treatment was 150 d and those without systemic treatment (chemotherapy and/or targeted therapy) after LM was 60 d (P = 0.001). Systemic therapy combined with local treatment (radiotherapy to the meninges or intrathecal chemotherapy) further improved the survival time of patients. Multivariate analysis showed that KPS and short-term therapeutic response for the LM were independent prognostic factors (P < 0.05 for both).</p><p><b>CONCLUSIONS</b>KPS and short-term therapeutic response are independent prognostic factores for leptomeningeal metastases from solid tumors. Systemic chemotherapy or targeted therapy can prolong the survival time. Systemic treatment (chemotherapy and/or targeted therapy) combined with radiation therapy or intrathecal injection may further improve the clinical outcomes.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Antineoplastic Combined Chemotherapy Protocols , Therapeutic Uses , Breast Neoplasms , Pathology , Combined Modality Therapy , Follow-Up Studies , Lung Neoplasms , Pathology , Meningeal Carcinomatosis , Drug Therapy , Radiotherapy , Multivariate Analysis , Particle Accelerators , Prognosis , Retrospective Studies , Stomach Neoplasms , Pathology , Survival RateABSTRACT
<p><b>OBJECTIVE</b>To summarize the diagnosis, pathology, treatment and prognosis of 8 cases of primary pulmonary sarcoma.</p><p><b>METHOD</b>The clinical data of 8 patients with primary pulmonary sarcoma in the PUMC Hospital from 1986 to 2009 were retrospectively analyzed.</p><p><b>RESULTS</b>The clinical manifestations included cough (n=5), chest pain (n=2), hemoptysis (n=2), short of breath (n=2), and hoarseness due to the oppression of the recurrent laryngeal nerve (n=1). The pathological diagnoses included leiomyosarcoma (n=1), synovial sarcoma (n=1), malignant fibrous histiocytoma (n=1), and unknown tumors due to poor differentiation (n=5). The 1- and 5-year survival rate was 37.5 % and 12.5%, respectively.</p><p><b>CONCLUSIONS</b>The primary pulmonary sarcoma is a rare disease with non-specific clinical manifestations. The early diagnosis is difficult and the prognosis is poor. Currently no satisfactory therapy is available for this disease.</p>