Lung cancer is one of the most common primary cancers that cause leptomeningeal carcinomatosis (LMC), when cancer spreads to the membranes surrounding the spinal cord and brain. Cases of LMC have increased because of the improved survival of lung cancer patients with the help of new advances in treatment. This is the type of cancer diagnosis facing Valerie Harper, who played Rhonda on “The Mary Tyler Moore Show.”
Now research published in the International Association for the Study of Lung Cancer’s Journal of Thoracic Oncology (JTO) shows the effectiveness of intraventricular chemotherapy (chemotherapy injected directly into the ventricles of the brain) in terms of symptom response rate and overall survival in patients with LMC from non-small cell lung cancer (NSCLC).
Researchers from the National Cancer Center in Goyang, Korea did a retrospective analysis on 105 patients with NSCLC who had undergone intraventricular chemotherapy. They conclude that intraventricular chemotherapy for patients with LMC from NSCLC could palliate associated symptoms and prolong patients’ survival.
“Among the 54 patients with increased ICP at the entry of the treatment,” the study says, “20 patients achieved normal ICP (< 15 cm H2O) after the intraventricular chemotherapy, excluding three patients who underwent a ventriculo-peritoneal shunt. However, 15 of 51 patients with normal ICP at the start of treatment showed increased ICP during the course of the therapy and remained uncontrolled. Thus, the total increased ICP control rate of intraventricular therapy was 20 of 69 (29 percent)."
As a result, the researchers conclude that, “Careful selection of patients for intraventricular chemotherapy is recommended, with aggressive ICP control, and concurrent systemic chemotherapy.”
The lead author of this work is Dr. Ho-Shin Gwak. Co-authors include IASLC members Dr. Sang Hoon Shin, Dr. Ji-Youn Han, Dr. Heung Tae Kim and Dr. Jin Soo Lee.
International Association for the Study of Lung Cancer