How would you manage leptomeningeal disease of the spine in the setting of prior WBRT?
What factors play into your decision whether to re-treat the brain with craniospinal radiotherapy vs irradiation of the spine only vs other measures (ie IT chemotherapy)?
Answer from: Radiation Oncologist at Academic Institution
This is an extremely challenging clinical situation. The decision points depend on treatment goals:
If the goal is local palliation, simply treat local areas of disease, e.g. spinal segments.
If effective systemic therapeutic options are available, obviously consider those first, including intra...