Leptomeningeal carcinomatosis from gastric cancer successfully treated by the intrathecal methotrexate plus temozolomide and simultaneous radiotherapy: Case report and literatures review

Cancer Biol Ther. 2017 Oct 3;18(10):761-764. doi: 10.1080/15384047.2017.1373218. Epub 2017 Sep 7.

Abstract

Leptomeningeal carcinomatosis (LMC) from gastrointestinal cancer is rare. A 56-year-old man with complaint of upper abdominal pain exhibited adenocarcinoma upon histopathologic examination of biopsy specimens. At the end of adjuvant chemotherapy, the patient was affected by hearing loss. Malignant cells were observed by cerebrospinal fluid (CSF) cytology. Therefore, the patient received intrathecal methotrexate and oral temozolomide chemotherapy and radiotherapy. The progress-free survival was approximately 11 months. To our knowledge, such cases of LMC from gastric cancer are very rare. Here, we describe the case of a patient with LMC from gastric cancer and review the literature associated with treatment. We hope that the present report may be helpful when considering how to improve treatment of LMC in gastric cancer patients and offer some tips for the adjuvant treatment modality.

Keywords: Gastric Cancer; Intrathecal; Radiotherapy; Temozolomide; leptomeningeal Carcinomatosis.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Abdominal Pain / etiology
  • Abdominal Pain / therapy
  • Adenocarcinoma / diagnostic imaging
  • Adenocarcinoma / pathology
  • Adenocarcinoma / secondary
  • Adenocarcinoma / therapy*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Biopsy
  • Chemoradiotherapy, Adjuvant / methods
  • Dacarbazine / analogs & derivatives*
  • Dacarbazine / therapeutic use
  • Gastroscopy
  • Humans
  • Injections, Spinal
  • Male
  • Meningeal Carcinomatosis / pathology
  • Meningeal Carcinomatosis / secondary
  • Meningeal Carcinomatosis / therapy*
  • Methotrexate / therapeutic use*
  • Middle Aged
  • Pylorus / pathology
  • Pylorus / surgery
  • Stomach Neoplasms / complications
  • Stomach Neoplasms / diagnostic imaging
  • Stomach Neoplasms / pathology
  • Stomach Neoplasms / therapy*
  • Temozolomide
  • Treatment Outcome

Substances

  • Dacarbazine
  • Temozolomide
  • Methotrexate