Les méningites carcinomateuses dans le cancer du poumon

Meningeal carcinomatosis is a fatal and late complication of advanced cancer. Its incidence is low (5% to 8% of solid tumors), but trends to increase because of prolonged patient survival and improved diagnosis tools. Meningeal involvement is more frequent in non-small cell lung cancer (NSCLC), breast cancer and melanoma. Its prognosis remains poor despite of improved treatments, with an overall survival after diagnosis of only 3 to 4 months with a specific treatment. Its diagnosis is difficult because of clinical and radiological heterogeneity, and it rests on cerebrospinal MRI and analysis of cerebrospinal fluid. Due to small and/or retrospective clinical trials, there are no guidelines on therapeutic strategies, particularly in lung cancer. Furthermore, performance status is commonly poor and patients could not benefit from clinical trials. The aim of this review was to make a point on the management of meningeal carcinomatosis in lung cancer patients.