CTNI-13. CONCURRENT INTRATHECAL CHEMOTHERAPY AND INVOLVED-FIELD RADIOTHERAPY FOR LEPTOMENINGEAL METASTASIS FROM SOLID TUMORS: A PHASE II STUDY (NCT03082144)

• DOI: 10.1093/neuonc/noad179.0295
• Publication Date: 2023-11-11T23:25:45Z
• Authors: Guozi Yang; Zhenyu Pan; Kunzhi Chen; Tongchao Jiang; Yuanyuan Song; Lihua Dong; Hua He; Xiaojun Ye; Min Wang; Tao Zhou
• Keywords: 0301 basic medicine; 0302 clinical medicine

Abstract BACKGROUND The role of involved-field radiation therapy (IFRT) and intrathecal chemotherapy (IC) in leptomeningeal metastasis (LM) from solid tumors was gradually underestimated the era targeted therapy. This study aimed to investigate safety effectiveness concurrent IFRT methotrexate (MTX)/cytarabine (Ara-C) for LM, particularly those who developed LM while receiving METHODS Enrolled patients were randomly assigned two subgroups (IFRT&IC-MTX IFRT&IC-Ara-C), first treated with induction IC (MTX or Ara-C) twice per week, up 4 times. Then given treatment, which consisted (40 Gy total; 2 Gy/f) 15 mg Ara-C 50 mg, once week). involved field symptomatic painful sites disease observed on magnetic resonance imaging (MRI), including whole brain basis crania and/or segment spinal canal. Primary endpoint clinical response rate (RR). Secondary endpoints overall survival (OS). RESULTS Fifty-three received MTX (n = 27) 26). Forty-two completed Total RR 34% (18/53). improvement neurological symptoms KPS scores 72% (38/53) 66% (35/53) respectively. Adverse events (AEs) 28% (15/53). Eight (15%, 8/53) showed grade 3-4 AEs, myelosuppression 4) radiculitis 5). Median OS 6.5 months (95% CI, 5.3-7.7 months). 18 had 7.9 4.4-11.4 months), 0.8 0.08-1.5 months) 6 progression. median 22 prior 6.3 4.5-8.1 CONCLUSION Concurrent proved be a feasible treatment option an acceptable profile common tumor entity.