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Surgical Treatment for Leptomeningeal Disease.

Authors
  • Volkov, Andrey A1
  • Filis, Andreas K2
  • Vrionis, Frank D3
  • 1 Neuro-Oncology Program, Moffitt Cancer Center, Tampa, FL.
  • 2 Imland Klinik, Rendsburg, Germany. [email protected] , (Germany)
  • 3 Marcus Neuroscience Institute, Boca Raton Regional Hospital and the Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL. [email protected]
Type
Published Article
Journal
Cancer control : journal of the Moffitt Cancer Center
Publication Date
Jan 01, 2017
Volume
24
Issue
1
Pages
47–53
Identifiers
PMID: 28178712
Source
Medline
Language
English
License
Unknown

Abstract

Advancements in cancer treatment have led to more cases of leptomeningeal disease, which requires a multimodal approach. Treatment modalities are reviewed from a neurosurgical standpoint, focusing on intrathecal chemotherapy and shunting devices. Potential complications and how to avoid them are discussed. The Ommaya reservoir and the chemoport are used for administering intrathecal chemotherapy. Use of ventriculo-lumbar perfusion can efficiently deliver chemotherapeutic agents and improve intracerebral pressure. Shunting systems, in conjunction with all of their variations, address the challenge of hydrocephalus in leptomeningeal carcinomatosis. Misplaced catheters, malfunction of the system, and shunt-related infections are known complications of treatment. From an oncological perspective, the surgical treatment for leptomeningeal disease is limited; however, neurosurgery can be used to aid in the administration of chemotherapy and address the issue of hydrocephalus. Minimizing surgical complications is important in this sensitive patient population.

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