Department of Neurology and Brain Tumor Center, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA.
J Neurooncol. 2010 Sep;99(2):283-6. doi: 10.1007/s11060-010-0128-6. Epub 2010 Feb 10.
Leptomeningeal metastases (LM) occur in 5-10% of patients with solid tumors and are associated with a dismal prognosis. We describe LM from lung adenocarcinoma harboring a mutation in the epidermal growth factor receptor (EGFR) gene that confers sensitivity to the EGFR tyrosine kinase inhibitors (EGFR-TKIs) erlotinib and gefitinib. The CSF concentration of EGFR-TKIs achieved by standard daily dosing may be insufficient for therapeutic effect. However, intermittent (pulsatile) high dose administration (1000-1500 mg/week) achieves a higher CSF concentration than standard dosing, and successfully controlled LM in this patient.
脑膜转移（LM）发生于 5-10%的实体瘤患者中，与预后不良相关。我们描述了一例肺腺癌脑膜转移患者，该患者的 EGFR 基因发生突变，对 EGFR 酪氨酸激酶抑制剂（EGFR-TKIs）厄洛替尼和吉非替尼敏感。标准日剂量给药时 EGFR-TKIs 在脑脊液中的浓度可能不足以达到治疗效果。然而，间歇性（脉冲式）高剂量给药（1000-1500mg/周）可实现比标准剂量更高的脑脊液浓度，并成功控制了该患者的 LM。
