Treatment of meningeal gliomatosis

To evaluate whether vigorous treatment is beneficial for patients with meni ngeal gliomatosis (MG) we reviewed the case records of 20 consecutive patie nts treated for a symptomatic MG in our center. All received systemic or in trathecal chemotherapy and six received additional cranial or spinal radiot herapy. Six patients (30%) achieved a partial response (one low-grade astro cytoma, two anaplastic astrocytomas, one anaplastic oligodendroglioma and t wo glioblastomas). In these cases, clinical improvement was associated with radiological improvement on CT scan or MRI in five and with a major cerebr ospinal fluid improvement in three. Three patients (15%) were stable for 3 months or more and 11 (55%) had progressive disease. Median survival was lo nger for the responding patients (10 months) than for the other patients (2 months). This study suggests that some patients with MG may benefit from a treatment combining radiotherapy to symptomatic areas and chemotherapy wit h agents that cross the blood-brain barrier or are delivered directly into the CSF.