Chamberlain M C
University of San Diego, California.
Curr Opin Oncol. 1992 Jun;4(3):533-9. doi: 10.1097/00001622-199206000-00018.
Leptomeningeal metastasis is a common neurologic disorder affecting the entire neuraxis in patients with metastatic systemic cancer and primary brain tumors. The clinical presentation of leptomeningeal metastasis is pleomorphic and commonly affects the cerebral hemispheres, cranial nerves, or spinal cord and its roots. Diagnosis is confirmed by the presence of malignant cells in the cerebrospinal fluid or by clinical and neuroradiographic pattern compatible with leptomeningeal metastasis. Treatment is palliative and is directed at the entire neuraxis combining involved-field radiotherapy and intra-cerebrospinal fluid drug administration. Regional chemotherapy pharmacokinetically is best administered by intraventricular instillation employing frequent drug administration, thereby insuring prolonged cytotoxic drug exposure. Chemotherapeutic drug distribution is dependent on bulk flow of cerebrospinal fluid. This review will summarize current information regarding the incidence, clinical presentation, laboratory findings, pathology, pathophysiology, staging, treatment, and survival of patients with leptomeningeal metastasis.
软脑膜转移是一种常见的神经系统疾病，影响转移性全身癌症和原发性脑肿瘤患者的整个神经轴。软脑膜转移的临床表现多样，通常影响大脑半球、颅神经或脊髓及其神经根。通过脑脊液中存在恶性细胞或通过与软脑膜转移相符的临床和神经影像学模式来确诊。治疗是姑息性的，针对整个神经轴，联合受累野放疗和脑脊髓液内给药。从药代动力学角度来看，区域化疗最好通过脑室内滴注进行，频繁给药，从而确保细胞毒性药物长时间暴露。化疗药物的分布取决于脑脊液的大量流动。本综述将总结有关软脑膜转移患者的发病率、临床表现、实验室检查结果、病理学、病理生理学、分期、治疗和生存的当前信息。
