Takenaka Tomoyoshi, Yamagata Motoyuki, Fukuda Atsushi, Sonoda Takashi
Thoracic Surgery Department, Kyushu Medical Center, Fukuoka, Japan.
BMJ Case Rep. 2011 Sep 13;2011:bcr0820114586. doi: 10.1136/bcr.08.2011.4586.
The treatment of carcinomatous meningitis in patients with non-small cell lung cancer is unsatisfactory with a median survival ranging from 4 to 6 weeks without treatment. This report presents a rare case of a long-term survivor with carcinomatous meningitis which was revealed during gefitinib therapy, and was treated with erlotinib. A 55-year-old female never-smoker was diagnosed with adenocarcinoma of the lung and underwent a right upper lobectomy. Four years had passed since surgery, she started gefitinib therapy for recurrent lung cancer. During gefitinib therapy, she presented with headache and was diagnosed with caricinomatous meningitis. After changing her treatment to erlotinib, her symptoms temporarily improved and she remained alive for 10 months. Erlotinib therapy may represent a candidate treatment option for carcinomatous meningitis after gefitinib therapy.
非小细胞肺癌患者的癌性脑膜炎治疗效果不理想，未经治疗时的中位生存期为4至6周。本报告介绍了1例罕见的癌性脑膜炎长期存活病例，该病例在吉非替尼治疗期间被发现，并接受了厄洛替尼治疗。一名55岁从不吸烟的女性被诊断为肺腺癌并接受了右上叶切除术。术后4年，她因复发性肺癌开始吉非替尼治疗。在吉非替尼治疗期间，她出现头痛，被诊断为癌性脑膜炎。将治疗改为厄洛替尼后，她的症状暂时改善，存活了10个月。厄洛替尼治疗可能是吉非替尼治疗后癌性脑膜炎的一种候选治疗选择。
