Yano Hirohito, Nakayama Noriyuki, Morimitsu Kasumi, Futamura Manabu, Ohe Naoyuki, Miwa Kazuhiro, Shinoda Jun, Iwama Toru
Department of Neurosurgery, Gifu University Graduate School of Medicine, Gifu, Japan.
Department of Surgical Oncology, Gifu University Graduate School of Medicine, Gifu, Japan.
Clin Med Insights Oncol. 2014 Dec 9;8:153-7. doi: 10.4137/CMO.S19823. eCollection 2014.
A 32-year-old woman underwent surgeries and radiation therapy for astrocytoma. She developed symptomatic radiation necrosis in the lesion, which caused hydrocephalus. She initially underwent ventricular drainage, because the protein level in the cerebrospinal fluid (CSF) was 787 mg/dL, which was too high for shunt surgery. Because she also had breast cancer, which was pathologically diagnosed as an invasive ductal carcinoma, standard bevacizumab therapy in combination with paclitaxel every 2 weeks was selected. Interestingly, after 2 days, the agents had dramatically reduced the CSF protein level. However, it returned to approximately the initial level within 2 weeks. After two courses of this regimen, a ventriculoperitoneal shunt was placed. After 10 courses of this regimen, the CSF protein level decreased to 338 mg/dL, which is less than half of the initial level. Long-term administration of bevacizumab might decrease leakage of protein from the vessels around the ventriculus.
一名32岁女性因星形细胞瘤接受了手术和放射治疗。她在病变部位出现了有症状的放射性坏死，进而导致脑积水。由于脑脊液（CSF）蛋白水平为787mg/dL，过高不适宜进行分流手术，她最初接受了脑室引流。因为她还患有乳腺癌，经病理诊断为浸润性导管癌，所以选择了每2周一次的标准贝伐单抗联合紫杉醇治疗。有趣的是，2天后，这些药物显著降低了脑脊液蛋白水平。然而，在2周内又恢复到了大约初始水平。经过两个疗程的这种治疗方案后，进行了脑室腹腔分流术。经过10个疗程的这种治疗方案后，脑脊液蛋白水平降至338mg/dL，不到初始水平的一半。长期使用贝伐单抗可能会减少脑室周围血管的蛋白渗漏。
