Hormonal ablation as effective therapy for carcinomatous meningitis from prostatic carcinoma Journal Article


Authors: Mencel, P. J.; DeAngelis, L. M.; Motzer, R. J.
Article Title: Hormonal ablation as effective therapy for carcinomatous meningitis from prostatic carcinoma
Abstract: Background. Metastases to the meninges from prostatic cancer are rare, accounting for less than 0.5% of all solid tumor cases. Management for patients with leptomeningeal metastases of various histologic types includes intrathecal chemotherapy and radiation therapy, but the prognosis is poor. Therefore, the identification of selected patients for whom effective therapy exists is of paramount importance. Methods. A patient with adenocarcinoma of the prostate presented with leptomeningeal metastases as his first manifestation of metastatic disease. Results. Androgen blockade was initiated with flutamide and ketoconazole. After 5 days of therapy, leuprolide acetate depot was substituted for ketoconazole. The patient responded to therapy and remained asymptomatic with a normal serum prostate‐specific antigen levels at 16‐plus months with no further evidence of malignant cells in spinal fluid from repeated lumbar punctures. Conclusions. Patients with hormone‐naive metastatic prostatic carcinoma manifested as carcinomatous meningitis should be considered for hormonal ablative therapy. This is preferred to the use of intrathecal chemotherapy, which has limited efficacy. Copyright © 1994 American Cancer Society
Keywords: aged; case report; drug efficacy; follow-up studies; adenocarcinoma; metastasis; antineoplastic combined chemotherapy protocols; dexamethasone; prostate cancer; prostatic neoplasms; leuprorelin; meningeal neoplasms; drug response; androgen ablation; androgen antagonists; hormonal therapy; flutamide; ketoconazole; meningitis; carcinomatous meningitis; leuprolide; intravenous drug administration; prostate carcinoma; oral drug administration; human; male; priority journal; article; hormonal ablative therapy
Journal Title: Cancer
Volume: 73
Issue: 7
ISSN: 0008-543X
Publisher: Wiley Blackwell  
Date Published: 1994-04-01
Start Page: 1892
End Page: 1894
Language: English
DOI: 10.1002/1097-0142(19940401)73:7<1892::Aid-cncr2820730720>3.0.Co;2-c
PROVIDER: scopus
PUBMED: 8137217
DOI/URL:
Notes: Export Date: 14 January 2019 -- Article -- Source: Scopus
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  1. Robert Motzer
    1243 Motzer