EANO-ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up of patients with leptomeningeal metastasis from solid tumours

Le Rhun, E.; Weller, M.; Brandsma, D.; Van den Bent, M.; de Azambuja, E.; Henriksson, R.; Boulanger, T.; Peters, S.; Watts, C.; Wick, W.; Wesseling, P.; Rudà, R.; Preusser, M.

doi:10.1093/annonc/mdx221

Cited by 637Brain Metastases and TreatmentManagement of metastatic bone diseaseGlioma Diagnosis and Treatment

EANO-ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up of patients with leptomeningeal metastasis from solid tumours

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Le Rhun, E., Weller, M., Brandsma, D., Van den Bent, M., de Azambuja, E., Henriksson, R., Boulanger, T., Peters, S. +5 more·2017·Annals of Oncology

DOI 10.1093/annonc/mdx221

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Intrathecal agents can cause a spectrum of toxicities ranging from myelosuppression to neurotoxicity.
“Their use can cause a spectrum of toxicities ranging from myelosuppression to neurotoxicity.”
From 5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5) (2020) · cites this paper as [101]
The Intra-CSF pharmacotherapy section reports neurological complications with intrathecal methotrexate, and the Clinical Practice Guidelines section reports more neurotoxicity in an intra-CSF chemotherapy arm. The paper attributes haematological toxicity to high-dose systemic chemotherapy, not intrathecal treatment, so it does not support myelosuppression as part of the claimed intrathecal toxicity spectrum. Page numbers are unavailable in our copy. (LLM, conf=0.87)
Experimental — accuracy not yet measured
Retrospective data suggest some activity of different agents used systemically.
“Retrospective data suggest some activity of different agents used systemically.100, 101, 102”
From 5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5) (2020) · cites this paper as [101]
Three agents are commonly used for intrathecal treatment of leptomeningeal disease: methotrexate, cytarabine (including liposomal cytarabine) or thioTEPA.
“Three agents are commonly used for intrathecal treatment of LMD: methotrexate, cytarabine (including liposomal cytarabine) or thioTEPA.100, 101, 102”
From 5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5) (2020) · cites this paper as [101]
Experimental — accuracy not yet measured

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“The EANO-ESMO CPG recommends considering focal RT for circumscribed, notably symptomatic lesions, andwhole-brain RT (WBRT) for extensive nodular or symptomatic linear LMD.101 The use of intrathecal therapy is controversial.”
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Authors: Le Rhun, E., Weller, M., Brandsma, D., Van den Bent, M., de Azambuja, E., Henriksson, R., Boulanger, T., Peters, S., Watts, C., Wick, W., Wesseling, P., Rudà, R., & Preusser, M.
Affiliations: University Hospital Zurich (CH)
University of Zurich (CH)
Centre Oscar Lambret (FR)
University of Cambridge (GB)
German Cancer Research Center (DE)
University Medical Center Utrecht (NL)
Comprehensive Cancer Center Vienna (AT)
ORCID: Weller, M.
Brandsma, D.
Henriksson, R.
Peters, S.
Watts, C.
Wick, W.
Wesseling, P.
Rudà, R.
Preusser, M.
Venue: Annals of Oncology
Publisher: Elsevier BV
Published: 2017-07
Volume: 28
Issue: 11
Pages: iv84-iv99
ISSN: 0923-7534 (ISSN-L)
DOI: 10.1093/annonc/mdx221
OpenAlex: W2734482945
Cited by: 637
References: 203
Citations by year: 2026: 33 · 2025: 81 · 2024: 131 · 2023: 127 · 2022: 109 · 2021: 59 · 2020: 35 · 2019: 39 · 2018: 18 · 2017: 2 · 2016: 1
FWCI: 21.26
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/open-access/userlicense/1.0/ (vor, 894 d)
Locations: Annals of Oncology (publishedVersion)
PubMed (publishedVersion)
Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
EUR Research Repository (Erasmus University Rotterdam) (publishedVersion)
Zurich Open Repository and Archive (University of Zurich) (acceptedVersion, other-oa)
Dépôt institutionnel de l'Université libre de Bruxelles (Université Libre de Bruxelles) (submittedVersion)
EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
RePub (Erasmus University Rotterdam) (submittedVersion, other-oa)
HAL (submittedVersion)
IRIS (submittedVersion)
Pure Amsterdam UMC (submittedVersion)
Radboud Repository (Radboud University) (submittedVersion)
SERVAL (Université de Lausanne) (submittedVersion)
Zurich Open Repository and Archive (University of Zurich) (submittedVersion, other-oa)
Data Archiving and Networked Services (DANS) (submittedVersion)
Zurich Open Repository and Archive (University of Zurich)
Funders: ESMO
Topics: Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Brain Metastases and Treatment
Health Sciences › Medicine › Surgery › Management of metastatic bone disease
Health Sciences › Medicine › Genetics › Glioma Diagnosis and Treatment
Keywords: leptomeningeal metastasis, solid tumors, diagnosis, treatment, follow-up, subarachnoid space
MeSH terms: Follow-Up Studies, Humans, Medical Oncology, Meningeal Neoplasms, Neoplasms

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EANO-ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up of patients with leptomeningeal metastasis from solid tumours

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