Mochizuki Sayaka, Nishimura Naoki, Inoue Akira, Murakami Koji, Nukiwa Toshihiro, Chohnabayashi Naohiko
Division of Pulmonary Medicine, St. Luke's International Hospital, 9-1Akashi-cho, Tokyo 104-8560, Japan.
Respir Investig. 2012 Sep;50(3):117-21. doi: 10.1016/j.resinv.2012.06.002. Epub 2012 Jul 15.
Here we report 2 cases of non-small cell lung cancer (NSCLC) with sensitive epidermal growth factor receptor (EGFR) gene mutation that developed miliary brain metastases characterized by dementia and disorientation during gefitinib therapy. One patient's therapy was switched from gefitinib to chemotherapy followed by whole brain radiotherapy (WBRT), which resulted in disease progression with coma. Gefitinib reinitiation improved the patient's symptoms. The other patient continued gefitinib during WBRT and achieved complete remission of the miliary metastases and lived 18 months longer. These results suggest that gefitinib concomitant with WBRT is an optional strategy for the treatment of patients with EGFR-mutated NSCLC with miliary metastases to prevent disease flare.
在此，我们报告2例非小细胞肺癌（NSCLC）患者，其表皮生长因子受体（EGFR）基因发生敏感突变，在吉非替尼治疗期间出现以痴呆和定向障碍为特征的粟粒性脑转移。1例患者的治疗从吉非替尼改为化疗，随后进行全脑放疗（WBRT），结果疾病进展并陷入昏迷。重新启用吉非替尼后患者症状改善。另1例患者在WBRT期间继续使用吉非替尼，粟粒性转移灶完全缓解，生存期延长了18个月。这些结果表明，吉非替尼与WBRT联合使用是治疗发生粟粒性转移的EGFR突变NSCLC患者以预防疾病复发的一种可选策略。
