Ommaya Reservoir-Based Cerebrospinal Fluid Chemotherapy for Leptomeningeal Metastasis in the Era of Targeted Therapy: Safety, Survival, and Exploratory Prognostic Factors from a Single-Center Cohort
- 1Department of Neurosurgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
- 2Department of Medical Oncology, Sanhuan Cancer Hospital, Chaoyang District, Beijing 100021, China
Abstract
Objective: Real-world data on Ommaya reservoir-based cerebrospinal fluid (CSF) chemotherapy for leptomeningeal metastasis (LM) in the targeted-therapy era are limited. We describe its safety and survival and explore prognostic factors in lung adenocarcinoma-associated LM. Methods: We retrospectively reviewed 68 patients with LM treated with Ommaya reservoir implantation and CSF chemotherapy. Overall survival (OS) was estimated from LM diagnosis and from implantation, and an exploratory multivariable Cox regression was performed in patients with actionable driver mutations receiving targeted therapy. Results: Device-related complications occurred in six patients (8.8%), including three catheter malpositions after freehand placement; chemotherapy-related adverse effects occurred in four (5.9%). After a median follow-up of 12.8 months, 14 patients (20.6%) had died, 10 of CNS progression. Median OS was not reached from diagnosis (24-month OS 67.8%) and 18.7 months from implantation (24-month OS 48.3%). In the exploratory analysis (n = 46), KPS, age, and EGFR mutation subtype were associated with OS from both time origins. Conclusions: Ommaya reservoir-based CSF chemotherapy was feasible with few device-related complications. Because all patients were treated and most had lung adenocarcinoma receiving targeted therapy, the favorable survival cannot be attributed to the reservoir or generalized to other primary tumors; prognostic factors require prospective validation.
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- Efficacy and safety of intrathecal chemotherapy in leptomeningeal disease: a global retrospective multicenter analysis and review of the literature
BibTeX
@article{li2026ommaya,
title = {{Ommaya Reservoir-Based Cerebrospinal Fluid Chemotherapy for Leptomeningeal Metastasis in the Era of Targeted Therapy: Safety, Survival, and Exploratory Prognostic Factors from a Single-Center Cohort}},
author = {Huaixu Li and Hongqing Cai and Xiaohong Lu and Qi Liu and Yujia Chen and Yulin Mi and Jinghai Wan},
journal = {Journal of Clinical Medicine},
year = {2026},
month = oct,
doi = {10.3390/jcm15207808},
url = {https://www.mdpi.com/2077-0383/15/20/7808},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Ommaya Reservoir-Based Cerebrospinal Fluid Chemotherapy for Leptomeningeal Metastasis in the Era of Targeted Therapy: Safety, Survival, and Exploratory Prognostic Factors from a Single-Center Cohort
AU - Huaixu Li
AU - Hongqing Cai
AU - Xiaohong Lu
AU - Qi Liu
AU - Yujia Chen
AU - Yulin Mi
AU - Jinghai Wan
PY - 2026
DA - 2026/10/10
JO - Journal of Clinical Medicine
DO - 10.3390/jcm15207808
UR - https://www.mdpi.com/2077-0383/15/20/7808
AB - Objective: Real-world data on Ommaya reservoir-based cerebrospinal fluid (CSF) chemotherapy for leptomeningeal metastasis (LM) in the targeted-therapy era are limited. We describe its safety and survival and explore prognostic factors in lung adenocarcinoma-associated LM. Methods: We retrospectively reviewed 68 patients with LM treated with Ommaya reservoir implantation and CSF chemotherapy. Overall survival (OS) was estimated from LM diagnosis and from implantation, and an exploratory multivariable Cox regression was performed in patients with actionable driver mutations receiving targeted therapy. Results: Device-related complications occurred in six patients (8.8%), including three catheter malpositions after freehand placement; chemotherapy-related adverse effects occurred in four (5.9%). After a median follow-up of 12.8 months, 14 patients (20.6%) had died, 10 of CNS progression. Median OS was not reached from diagnosis (24-month OS 67.8%) and 18.7 months from implantation (24-month OS 48.3%). In the exploratory analysis (n = 46), KPS, age, and EGFR mutation subtype were associated with OS from both time origins. Conclusions: Ommaya reservoir-based CSF chemotherapy was feasible with few device-related complications. Because all patients were treated and most had lung adenocarcinoma receiving targeted therapy, the favorable survival cannot be attributed to the reservoir or generalized to other primary tumors; prognostic factors require prospective validation.
SN - 2077-0383
ER -