Wong Eric T, Wu Julian K, Mahadevan Anand
Department of Neurology.
Biologics. 2007 Sep;1(3):321-4.
Carcinomatous encephalitis is a rapidly fatal form of metastasis caused by miliary spread of systemic cancer into the brain parenchyma. The diagnostic criteria and optimal treatment for this disease are not well defined. We report a patient with rapid neurologic deterioration from carcinomatous encephalitis from lung adenocarcinoma. She was treated with gefitinib and high-dose fractionated whole brain radiotherapy, and eventually improved neurologically and was discharged home on hospital day 48. Gefitinib and high-dose fractionated radiotherapy may have synergistic activity in patients with carcinomatous encephalitis from non-small cell lung cancer having favorable prognostic factors. More importantly, timely recognition of this disease and the use of large fraction radiation therapy are necessary to control rapid neurologic deterioration.
癌性脑炎是一种由全身性癌症经血行播散至脑实质引起的快速致命性转移形式。该疾病的诊断标准和最佳治疗方法尚不明确。我们报告一名因肺腺癌导致癌性脑炎而出现快速神经功能恶化的患者。她接受了吉非替尼和大剂量分次全脑放疗，最终神经功能得到改善，并于住院第48天出院回家。吉非替尼和大剂量分次放疗可能对具有良好预后因素的非小细胞肺癌所致癌性脑炎患者具有协同活性。更重要的是，及时识别这种疾病并采用大分割放疗对于控制快速神经功能恶化是必要的。
