ArticleNeuro-oncology2019
A multi-institutional analysis of presentation and outcomes for leptomeningeal disease recurrence after surgical resection and radiosurgery for brain metastases.
Article in Neuro-oncology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 65 papers, 4 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
65 citing papers in PubMed, 4 syntheses or guidelines pooled it, 106 citations in OpenAlex.
- Brain metastases: A Society for Neuro-Oncology (SNO) consensus review on current management and future directions.Neuro-oncology · 2022Guideline
- The Role of Immune Checkpoint Inhibitors in Leptomeningeal Disease: A Systematic Review.Anticancer research · 2021Pooled it
- A systematic review of craniospinal irradiation for leptomeningeal disease: past, present, and future.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2021Pooled it
- Radiotherapy in Leptomeningeal Disease: A Systematic Review of Randomized and Non-randomized Trials.Frontiers in oncology · 2019Pooled it
- Nodular Meningeal Recurrence After Laser Interstitial Thermal Therapy for Brain Metastasis: Diagnostic Challenges and Role of Reirradiation With Preoperative Fractionated Stereotactic Radiation Therapy.Advances in radiation oncology · 2026Article
- Long-term safety and efficacy of staged stereotactic radiosurgery with Ommaya reservoir aspiration for large cystic brain metastases.Journal of neuro-oncology · 2026Article
- Clinical outcomes of three-fraction versus five-fraction stereotactic radiosurgery for resected brain metastases.Journal of neuro-oncology · 2026Article
- [Chinese Expert Consensus on Clinical Management of Oncogene Addicted Non-small Cell Lung Cancer with Leptomeningeal Metastasis (2026 Edition)].Zhongguo fei ai za zhi = Chinese journal of lung cancer · 2026Article
- Development and validation of a predictive nomogram for leptomeningeal metastasis risk in NSCLC brain metastases: role of tumor location, driver mutations, and stereotactic radiosurgery.Journal of neuro-oncology · 2025Article
- Preoperative Stereotactic Radiosurgery for Brain Metastases: A Phase 1 Dose Escalation Study Demonstrating Reduced Leptomeningeal Disease.Advances in radiation oncology · 2025Article
- Incidental Brain Metastases From Prostate Cancer Diagnosed With PSMA PET/CT and MRI: A Case Series and Literature Review.The Prostate · 2025Review
- Stereotactic radiosurgery for patients with brain metastases: current principles, expanding indications and opportunities for multidisciplinary care.Nature reviews. Clinical oncology · 2025Review
- Article
- Brain metastases from lung cancer: recent advances and novel therapeutic opportunities.Discover oncology · 2025Review
- Leptomeningeal metastatic disease: new frontiers and future directions.Nature reviews. Clinical oncology · 2025Review
- Development of a scoring system to predict local recurrence in brain metastases following complete resection and observation.Journal of neuro-oncology · 2024Article
- Radiotherapy and Systemic Treatment for Leptomeningeal Disease.Biomedicines · 2024Review
- Comparative evaluation of outcomes amongst different radiosurgery management paradigms for patients with large brain metastasis.Journal of neuro-oncology · 2024Article
- Prognostic impact of clinical and radiological factors on leptomeningeal metastasis from solid cancers.Journal of neuro-oncology · 2024Article
- Novel radiotherapeutic strategies in the management of brain metastases: Challenging the dogma.Neuro-oncology · 2024Review
5 more citing papers are in PubMed but not listed here.
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Authors and funding
19 authors at 11 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRadiographic leptomeningeal disease (LMD) develops in up to 30% of patients following postoperative stereotactic radiosurgery (SRS) for brain metastases. However, the clinical relevancy of this finding and outcomes after various salvage treatments are not known.
methodsPatients with brain metastases, of which 1 was resected and treated with adjunctive SRS, and who subsequently developed LMD were combined from 7 tertiary care centers. LMD pattern was categorized as nodular (nLMD) or classical ("sugarcoating," cLMD).
resultsThe study cohort was 147 patients. Most patients (60%) were symptomatic at LMD presentation, with cLMD more likely to be symptomatic than nLMD (71% vs. 51%, P = 0.01). Salvage therapy was whole brain radiotherapy (WBRT) alone (47%), SRS (27%), craniospinal radiotherapy (RT) (10%), and other (16%), with 58% receiving a WBRT-containing regimen. WBRT was associated with lower second LMD recurrence compared with focal RT (40% vs 68%, P = 0.02). Patients with nLMD had longer median overall survival (OS) than those with cLMD (8.2 vs 3.3 mo, P < 0.001). On multivariable analysis for OS, pattern of initial LMD (nodular vs classical) was significant, but type of salvage RT (WBRT vs focal) was not.
conclusionsNodular LMD is a distinct pattern of LMD associated with postoperative SRS that is less likely to be symptomatic and has better OS outcomes than classical "sugarcoating" LMD. Although focal RT demonstrated increased second LMD recurrence compared with WBRT, there was no associated OS detriment. Focal cranial RT for nLMD recurrence after surgery and SRS for brain metastases may be a reasonable alternative to WBRT.
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