Articles

Leptomeningeal carcinomatosis from solid tumours: a systematic review of the literature

BJMO - volume 11, issue 6, october 2017

P. Frères MD, C. Gennigens MD, PhD, D. Martin MD, PhD, G. Jerusalem MD, PhD

SUMMARY

Leptomeningeal carcinomatosis (LC), or neoplastic meningitis, is a disastrous complication of advanced cancer. This disease occurs in approximately 5% of patients with solid tumour and results from the dissemination of tumour cells from the cerebral spinal fluid (CSF) flow throughout the entire central nervous system (CNS). LC is characterized by multiple and fluctuant neurologic symptoms and signs. Useful tests for the diagnosis include magnetic resonance imaging (MRI) and CSF analysis. Unfortunately, the diagnosis remains challenging due to pleomorphic symptoms and false negative results of diagnostic procedures. For most patients, the aim of the treatment is to control symptoms, by using targeted radiotherapy and corticosteroids. More aggressive therapeutic approaches, such as intrathecal (IT) or systemic chemotherapy, should be restricted to highly selected and good-risk patients. Moreover, only few randomized clinical trials are available in the field and studies using more recent targeted therapies or immunotherapy should always be considered in these patients, as outcome with standard of care is disappointing.

(BELG J MED ONCOL 2017;11(6):259–264)

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Management and systemic treatment of clear cell metastatic renal cell carcinoma: BSMO expert panel recommendations

BJMO - volume 9, issue 1, february 2015

Z. El Ali MD, PhD, D. Van Brummelen MD, P. Wolter MD, S. Rottey MD, PhD, S. Altintas MD, PhD, D. Schallier MD, PhD, P. Debruyne MD, PhD, C. Gennigens MD, PhD, F. Van Aelst MD, S. Sideris MD, T. Gil MD, N. Sirtaine MD, L. D’Hondt MD, PhD, D. Luyten MD, C. Focan MD, PhD, G. Matus MD, M. Rasschaert MD, G. Pelgrims MD, the BSMO Renal Cancer Task Force Group

Almost 30% of patients with renal cell cancer present initially with advanced stage IV disease. In the past decade, the management of the metastatic renal cell cancer has been revolutionised by the knowledge of its molecular biology and development of targets against vascular endothelial growth factor and mammalian target of rapamycin pathways. In this paper we present recommendations based on a thorough review of available guidelines and data from the phase III randomised controlled trials that evaluated new agents in patients with advanced metastatic renal cancer.
(BELG J MED ONCOL 2015;9(1):16–24)

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