癌性脑膜炎：手术和伽玛刀放射外科治疗是危险因素吗？
Carcinomatous meningitis: are surgeryand gamma knife radiosurgery treatment risk factors?
作者信息
Mahajan Anita, Borden Jonathan, Tsai Jen-San
机构信息
Department of Radiation Oncology, Tufts-New England Medical Center, Tufts University, Boston, Massachusetts 02111, USA.
出版信息
J Neurosurg. 2002 Dec;97(5 Suppl):441-4. doi: 10.3171/jns.2002.97.supplement.
OBJECT
The purpose of this study was to identify possible risk factors leading to carcinomatous meningitis in patients with a known brain metastasis and who were treated with gamma knife radiosurgery (GKS).
METHODS
Two hundred eighty lesions in 101 patients were treated during 121 GKS procedures. The clinical and neuroimaging history, tumor histology, and follow-up studies were reviewed for all patients. Evidence as demonstrated by magnetic resonance imaging criteria and/or cerebrospinal fluid (CSF) cytology of carcinomatous meningitis was evaluated. The data were then analyzed to identify potential risk factors for the development of CSF dissemination.
CONCLUSIONS
It appears that carcinomatous meningitis is exclusively identified in patients with adenocarcinoma, in particular with primary lung cancer. Furthermore, the incidence is higher if surgery is performed and the interval to subsequent GKS is prolonged.
目的
本研究旨在确定已知脑转移瘤且接受伽玛刀放射外科治疗（GKS）的患者发生癌性脑膜炎的可能危险因素。
方法
在121次GKS治疗过程中，对101例患者的280个病灶进行了治疗。回顾了所有患者的临床和神经影像学病史、肿瘤组织学及随访研究。评估磁共振成像标准和/或脑脊液（CSF）细胞学检查所证实的癌性脑膜炎证据。然后对数据进行分析，以确定脑脊液播散发生的潜在危险因素。
结论
似乎癌性脑膜炎仅在腺癌患者中出现，尤其是原发性肺癌患者。此外，如果进行了手术且至后续GKS的间隔时间延长，其发生率会更高。
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