The Comparative Treatment of Intraventricular Chemotherapy by Ommaya Reservoir vs. Lumbar Puncture in Patients With Leptomeningeal Carcinomatosis
Object: Leptomeningeal Carcinomatosis (LCM) represents a state of systemic malignant disease with poor prognosis. The purpose of this study is to compare overall survival (OS) between intraventricular chemotherapy through Ommaya reservoir (OR) and chemotherapy through lumbar puncture (LP) in LCM.Pat...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2018-11-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fonc.2018.00509/full |
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Article |
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DOAJ |
| language |
English |
| format |
Article |
| sources |
DOAJ |
| author |
Mariano Montes de Oca Delgado Bernardo Cacho Díaz José Santos Zambrano Vicente Guerrero Juárez Manuel Salvador López Martínez Elvira Castro Martínez Javier Avendaño Méndez-Padilla Javier Avendaño Méndez-Padilla Sonia Mejía Pérez Sonia Mejía Pérez Ignacio Reyes Moreno Axayacatl Gutiérrez Aceves Axayacatl Gutiérrez Aceves Alberto González Aguilar Alberto González Aguilar Alberto González Aguilar Alberto González Aguilar |
| spellingShingle |
Mariano Montes de Oca Delgado Bernardo Cacho Díaz José Santos Zambrano Vicente Guerrero Juárez Manuel Salvador López Martínez Elvira Castro Martínez Javier Avendaño Méndez-Padilla Javier Avendaño Méndez-Padilla Sonia Mejía Pérez Sonia Mejía Pérez Ignacio Reyes Moreno Axayacatl Gutiérrez Aceves Axayacatl Gutiérrez Aceves Alberto González Aguilar Alberto González Aguilar Alberto González Aguilar Alberto González Aguilar The Comparative Treatment of Intraventricular Chemotherapy by Ommaya Reservoir vs. Lumbar Puncture in Patients With Leptomeningeal Carcinomatosis Frontiers in Oncology leptomeningeal carcinomatosis overall survival chemotherapy ommaya reservoir lumbar puncture karnofsky performance status |
| author_facet |
Mariano Montes de Oca Delgado Bernardo Cacho Díaz José Santos Zambrano Vicente Guerrero Juárez Manuel Salvador López Martínez Elvira Castro Martínez Javier Avendaño Méndez-Padilla Javier Avendaño Méndez-Padilla Sonia Mejía Pérez Sonia Mejía Pérez Ignacio Reyes Moreno Axayacatl Gutiérrez Aceves Axayacatl Gutiérrez Aceves Alberto González Aguilar Alberto González Aguilar Alberto González Aguilar Alberto González Aguilar |
| author_sort |
Mariano Montes de Oca Delgado |
| title |
The Comparative Treatment of Intraventricular Chemotherapy by Ommaya Reservoir vs. Lumbar Puncture in Patients With Leptomeningeal Carcinomatosis |
| title_short |
The Comparative Treatment of Intraventricular Chemotherapy by Ommaya Reservoir vs. Lumbar Puncture in Patients With Leptomeningeal Carcinomatosis |
| title_full |
The Comparative Treatment of Intraventricular Chemotherapy by Ommaya Reservoir vs. Lumbar Puncture in Patients With Leptomeningeal Carcinomatosis |
| title_fullStr |
The Comparative Treatment of Intraventricular Chemotherapy by Ommaya Reservoir vs. Lumbar Puncture in Patients With Leptomeningeal Carcinomatosis |
| title_full_unstemmed |
The Comparative Treatment of Intraventricular Chemotherapy by Ommaya Reservoir vs. Lumbar Puncture in Patients With Leptomeningeal Carcinomatosis |
| title_sort |
comparative treatment of intraventricular chemotherapy by ommaya reservoir vs. lumbar puncture in patients with leptomeningeal carcinomatosis |
| publisher |
Frontiers Media S.A. |
| series |
Frontiers in Oncology |
| issn |
2234-943X |
| publishDate |
2018-11-01 |
| description |
Object: Leptomeningeal Carcinomatosis (LCM) represents a state of systemic malignant disease with poor prognosis. The purpose of this study is to compare overall survival (OS) between intraventricular chemotherapy through Ommaya reservoir (OR) and chemotherapy through lumbar puncture (LP) in LCM.Patients and Methods: Forty adult patients with LCM were included. All patients underwent lumbar puncture and Magnetic resonance imaging (MRI). Thirty patients received chemotherapy through LP and 10 undergone colocation of Ommaya reservoir for intraventricular chemotherapy.Results: The most common symptom was headache (Present in 50%). The cranial nerves most affected were VI and VII. Leptomeningeal enhancement was the most frequent finding in MRI. The OS in the LP group was 4 months and Ommaya group was 9.2 months (p = 0.0006; CI:1.8-3), with statistical differences in favor to Intraventricular treatment. Proportional hazard regression showed that receiving chemotherapy through Ommaya reservoir was a protective factor (Hazard ratio = 0.258, Standard Error = 0.112, p = 0.002 and 95% CI 0.110-0.606). Using KPS as a factor did not affect the hazard ratio of Ommaya reservoir itself.Conclusions: OS was significantly higher in patients with Ommaya reservoir in spite of Karnofsky Performance Status (KPS) previous to chemotherapy. Therefore, intraventricular chemotherapy should be preferred over lumbar puncture chemotherapy administration if there are resources available. |
| topic |
leptomeningeal carcinomatosis overall survival chemotherapy ommaya reservoir lumbar puncture karnofsky performance status |
| url |
https://www.frontiersin.org/article/10.3389/fonc.2018.00509/full |
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doaj-6eceada74693485cb89ca53a7dc844c02020-11-25T00:23:41ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2018-11-01810.3389/fonc.2018.00509415682The Comparative Treatment of Intraventricular Chemotherapy by Ommaya Reservoir vs. Lumbar Puncture in Patients With Leptomeningeal CarcinomatosisMariano Montes de Oca Delgado0Bernardo Cacho Díaz1José Santos Zambrano2Vicente Guerrero Juárez3Manuel Salvador López Martínez4Elvira Castro Martínez5Javier Avendaño Méndez-Padilla6Javier Avendaño Méndez-Padilla7Sonia Mejía Pérez8Sonia Mejía Pérez9Ignacio Reyes Moreno10Axayacatl Gutiérrez Aceves11Axayacatl Gutiérrez Aceves12Alberto González Aguilar13Alberto González Aguilar14Alberto González Aguilar15Alberto González Aguilar16Emergency Department, National Institute of Neurology and Neurosurgery “Manuel Velasco Suárez” (INNN), Mexico City, MexicoNeuroscience Unit, National Cancer Institute, Mexico City, MexicoEmergency Department, National Institute of Neurology and Neurosurgery “Manuel Velasco Suárez” (INNN), Mexico City, MexicoEmergency Department, National Institute of Neurology and Neurosurgery “Manuel Velasco Suárez” (INNN), Mexico City, MexicoEmergency Department, National Institute of Neurology and Neurosurgery “Manuel Velasco Suárez” (INNN), Mexico City, MexicoEmergency Department, National Institute of Neurology and Neurosurgery “Manuel Velasco Suárez” (INNN), Mexico City, MexicoNeurosurgery Department, National Institute of Neurology and Neurosurgery “Manuel Velasco Suárez” (INNN), Mexico City, MexicoNeurooncology Department, National Institute of Neurology and Neurosurgery “Manuel Velasco Suárez” (INNN), Mexico City, MexicoNeurosurgery Department, National Institute of Neurology and Neurosurgery “Manuel Velasco Suárez” (INNN), Mexico City, MexicoNeurooncology Department, National Institute of Neurology and Neurosurgery “Manuel Velasco Suárez” (INNN), Mexico City, MexicoNeurological Service, The American British Cowdray Medical Center, Mexico City, MexicoNeurological Service, The American British Cowdray Medical Center, Mexico City, MexicoRadioneurosurgery Department, National Institute of Neurology and Neurosurgery “Manuel Velasco Suárez” (INNN), Mexico City, MexicoEmergency Department, National Institute of Neurology and Neurosurgery “Manuel Velasco Suárez” (INNN), Mexico City, MexicoNeurosurgery Department, National Institute of Neurology and Neurosurgery “Manuel Velasco Suárez” (INNN), Mexico City, MexicoNeurooncology Department, National Institute of Neurology and Neurosurgery “Manuel Velasco Suárez” (INNN), Mexico City, MexicoNeurological Service, The American British Cowdray Medical Center, Mexico City, MexicoObject: Leptomeningeal Carcinomatosis (LCM) represents a state of systemic malignant disease with poor prognosis. The purpose of this study is to compare overall survival (OS) between intraventricular chemotherapy through Ommaya reservoir (OR) and chemotherapy through lumbar puncture (LP) in LCM.Patients and Methods: Forty adult patients with LCM were included. All patients underwent lumbar puncture and Magnetic resonance imaging (MRI). Thirty patients received chemotherapy through LP and 10 undergone colocation of Ommaya reservoir for intraventricular chemotherapy.Results: The most common symptom was headache (Present in 50%). The cranial nerves most affected were VI and VII. Leptomeningeal enhancement was the most frequent finding in MRI. The OS in the LP group was 4 months and Ommaya group was 9.2 months (p = 0.0006; CI:1.8-3), with statistical differences in favor to Intraventricular treatment. Proportional hazard regression showed that receiving chemotherapy through Ommaya reservoir was a protective factor (Hazard ratio = 0.258, Standard Error = 0.112, p = 0.002 and 95% CI 0.110-0.606). Using KPS as a factor did not affect the hazard ratio of Ommaya reservoir itself.Conclusions: OS was significantly higher in patients with Ommaya reservoir in spite of Karnofsky Performance Status (KPS) previous to chemotherapy. Therefore, intraventricular chemotherapy should be preferred over lumbar puncture chemotherapy administration if there are resources available.https://www.frontiersin.org/article/10.3389/fonc.2018.00509/fullleptomeningeal carcinomatosisoverall survivalchemotherapyommaya reservoirlumbar puncturekarnofsky performance status |