Gaviani Paola, Silvani A, Corsini E, Erbetta A, Salmaggi A
Neuro Oncology Department, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
Neurol Sci. 2009 Jun;30(3):251-4. doi: 10.1007/s10072-009-0044-8. Epub 2009 Mar 4.
Neoplastic meningitis from breast cancer often leads to a progressive neurologic deterioration followed by fatal outcome. The therapy is based on the administration of high dose systemic chemotherapy with drugs able to pass through the blood-brain barrier, such as methotrexate (MTX) and cytarabine, cranial or craniospinal irradiation, and intrathecal (IT) administration of MTX and/or cytarabine. However, these approaches only have modest efficacy and are associated with side effects for the patients. A depot formulation of liposomal cytarabine (DepoCyte) has proven to be useful in clinical trials. We describe the case of a woman with a diagnosis of leptomeningeal carcinomatosis from breast carcinoma who presented cerebrospinal fluid normalization and prolonged complete MRI response to intrathecal chemotherapy with liposomal cytarabine (DepoCyte).
乳腺癌所致的肿瘤性脑膜炎常导致进行性神经功能恶化,最终导致死亡。治疗方法包括使用能够透过血脑屏障的药物进行高剂量全身化疗,如甲氨蝶呤(MTX)和阿糖胞苷,进行颅脑或全脑全脊髓照射,以及鞘内注射MTX和/或阿糖胞苷。然而,这些方法疗效有限,且会给患者带来副作用。脂质体阿糖胞苷长效注射剂(DepoCyte)在临床试验中已被证明是有效的。我们报告了一例诊断为乳腺癌软脑膜转移的女性患者,该患者接受脂质体阿糖胞苷(DepoCyte)鞘内化疗后,脑脊液恢复正常,MRI完全缓解期延长。