雑誌文献を検索します。書籍を検索する際には「書籍検索」を選択してください。

検索

書誌情報 詳細検索 by 医中誌

Japanese

Multidisciplinary Treatment of Leptomeningeal Metastasis in Patients with Lung Adenocarcinoma: The Triple Modality Combination of EGFR-TKI,VP Shunt and Irradiation Koichi MITSUYA 1 , Yoko NAKASU 1 , Yoshihito MIZOKAMI 1 , Toshiaki TAKAHASHI 2 , Yukiko NAKAMURA 2 , Akira ONO 2 , Yoko TODA 2 , Nobuyuki YAMAMOTO 2 , Hideyuki HARADA 3 , Tetsuo NISHIMURA 3 1Division of Neurosurgery,Shizuoka Cancer Center 2Division of Thoracic Oncology,Shizuoka Cancer Center 3Division of Radiation Oncology,Shizuoka Cancer Center Keyword: lung cancer , leptomeningeal metastasis , EGFR-tyrosine kinase inhibitor , ventriculo-peritoneal shunt , radiation therapy pp.503-509
Published Date 2012/6/10
DOI https://doi.org/10.11477/mf.1436101743
  • Abstract
  • Look Inside
  • Reference

 Background: Leptomeningeal metastasis (LM) is a devastating complication of systemic cancers. New therapies that have beneficial effects on primary cancers outside the central nervous system (CNS) have underscored the significance of LM. Intrathecal chemotherapy plus radiation therapy are less effective for LM from lung adenocarcinoma. We retrospectively studied outcomes of patients with LM from lung adenocarcinoma who underwent multidisciplinary treatments in our institute.

 Methods: Four patients with LM from lung adenocarcinoma treated with EGFR-TKI, VP shunt and irradiation. Of those four, two presented with increased intracranial pressure, one with epilepsy, and the other with truncal ataxia. Treatment was indicated when LM was confirmed by MR images or cytology, and Karnofsky Performance Status scale was more than 40%, and life expectancy was more than three months if LM was controlled. EGFR mutation was not examined, because of the unsettled approval of Japanese public health insurance at the time of this study. The patients selected for treatment by EGFR-TKI were all Asian women who had never smoked. Treatment sequence was based on clinical symptoms depending on the individual situation.

 Result: The mean time from diagnosis of lung adenocarcinoma to LM onset was 28 (24 to 36) months. Mean survival time from LM diagnosis was 9 months. All patients died of LM. No patients suffered from peritoneal carcinomatosis or infection after VP shunt.

 Conclusion: The triple modality combination of EGFR-TKI,VP shunt and radiation therapy may improve outcomes and symptoms of patients with LM from lung adenocarcinoma.


Copyright © 2012, Igaku-Shoin Ltd. All rights reserved.

基本情報

電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院

関連文献

もっと見る

文献を共有