Bruna et al reported prognostic factors for a patient with leptomeningeal carcinomatosis. These can help to identify a patient who is more likely to have a longer survival. The authors are from University of Bellvitge, the University of Barcelona and several cancer hospitals in Spain.
Parameters:
(1) RTOG neurological score
(2) glucose level in the CSF
(3) infratentorial symptoms at onset (cranial nerve palsy; radicular or spinal involvement)
Parameter |
Finding |
Points |
RTOG neurological score |
3 or 4 |
0 |
|
1 or 2 |
1 |
glucose level in CSF |
< 2.7 mmol/L |
0 |
|
>= 2.7 mmol/L (49 mg/dL) |
1 |
infratentorial symptoms at onset |
absent |
0 |
|
present |
1 |
where:
• An RTOG of 2 indicates the ability to perform normal activities with minimal difficulty and without the need for nursing care.
total number of favorable findings =
= SUM(points for all 3 parameters)
Interpretation:
• minimum number of favorable findings: 0
• maximum number of favorable findings: 3
• The greater the number of favorable findings the better the survival.
• The type of cancer will impact overall survival. A patient with breast cancer tends to live longer than a patient with lung cancer.
• The mortality rate for the higher risk group was almost 100% at 150 days. About 20% of the lower risk group had survival to a year or more.
• Administering intrathecal chemotherapy improved survival.
Total Score |
Risk Group |
Median Survival |
0 or 1 |
worse |
25 days |
2 or 3 |
better |
90 days |
Specialty: Hematology Oncology, Surgery, general
ICD-10: ,