Neuro-Oncology, Nancy Hospital, France.
Lancet Oncol. 2010 Sep;11(9):871-9. doi: 10.1016/S1470-2045(10)70034-6. Epub 2010 Jul 2.
Neoplastic meningitis consists of diffuse involvement of the leptomeninges by infiltrating cancer cells, and can be caused by systemic or primary CNS tumours, such as solid cancers or lymphoproliferative malignant disease. Neoplastic meningitis is characterised by multifocal neurological signs and symptoms. Thus, careful neurological examination is needed for diagnosis of secondary diffuse involvement. Survival of patients with neoplastic meningitis is short (3-4 months), although some patients have long-lasting remission. Because most patients with neoplastic meningitis have diffuse systemic disease, treatment is typically palliative. However, more aggressive treatments are available to low-risk patients, which could increase survival. Therefore, identification of low-risk patients is important. Intrathecal chemotherapy is currently the main treatment for patients with neoplastic meningitis, but optimum anticancer chemotherapy is being studied.
癌性脑膜炎是指癌细胞浸润脑膜引起的弥漫性脑膜受累，可由全身或中枢神经系统原发性肿瘤引起，如实体瘤或淋巴增生性恶性疾病。癌性脑膜炎的特征是多灶性神经体征和症状。因此，需要仔细的神经系统检查以诊断继发性弥漫性受累。尽管一些患者有持久缓解，但患有癌性脑膜炎的患者的生存时间很短（3-4 个月）。由于大多数癌性脑膜炎患者有弥漫性全身疾病，因此治疗通常是姑息性的。然而，对于低危患者可采用更积极的治疗方法，这可能会提高生存率。因此，识别低危患者很重要。鞘内化疗是目前治疗癌性脑膜炎患者的主要方法，但正在研究最佳的抗癌化疗方案。
