Chamberlain Marc C
Department of Neuro-Oncology, University of S Florida, H. Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Dr, Suite 3136, Tampa, FL 33612, USA.
J Clin Oncol. 2005 May 20;23(15):3605-13. doi: 10.1200/JCO.2005.01.131.
Neoplastic meningitis (NM) is a common problem in neuro-oncology occurring in approximately 5% of all patients with cancer, and is the third most common site of CNS metastases. NM is a disease affecting the entire neuraxis, and therefore clinical manifestations are pleomorphic affecting the spine, cranial nerves, and cerebral hemispheres. Because of craniospinal disease involvement, staging and treatment need to encompass all CSF compartments. Treatment of NM utilizes involved-field radiotherapy of bulky or symptomatic disease sites and intra-CSF drug therapy. The inclusion of concomitant systemic therapy may benefit patients with NM and may obviate the need for intra-CSF chemotherapy. At present, intra-CSF drug therapy is confined to three chemotherapeutic agents (ie, methotrexate, cytarabine, and thiotepa) administered by a variety of schedules either by intralumbar or intraventricular drug delivery. Although treatment of NM is palliative with an expected median patient survival of 2 to 6 months, it often affords stabilization and protection from further neurologic deterioration in patients with NM.
肿瘤性脑膜炎（NM）是神经肿瘤学中的常见问题，约占所有癌症患者的5%，是中枢神经系统转移的第三常见部位。NM是一种影响整个神经轴的疾病，因此临床表现多样，累及脊柱、颅神经和大脑半球。由于颅脊髓疾病受累，分期和治疗需要涵盖所有脑脊液腔室。NM的治疗采用对体积较大或有症状的疾病部位进行受累野放疗和脑脊液内药物治疗。联合全身治疗可能使NM患者受益，并可能无需进行脑脊液内化疗。目前，脑脊液内药物治疗仅限于三种化疗药物（即甲氨蝶呤、阿糖胞苷和噻替派），通过多种给药方案经腰椎或脑室内给药。虽然NM的治疗是姑息性的，患者预期中位生存期为2至6个月，但它通常能使NM患者病情稳定，防止进一步神经功能恶化。
