Roth Patrick, Weller Michael
Department of Neurology, University Hospital Zurich, Frauenklinikstrasse 26, CH-8091 Zurich, Switzerland.
Department of Neurology, Brain Tumor Center Zurich, University Hospital Zurich and University of Zurich, Zurich, Switzerland.
Chin Clin Oncol. 2015 Jun;4(2):26. doi: 10.3978/j.issn.2304-3865.2015.05.02.
Leptomeningeal dissemination of tumor cells, also referred to as neoplastic meningitis, is most frequently seen in patients with late-stage cancer and mostly associated with a poor prognosis. Basically, neoplastic meningitis may affect all patients with a malignant tumor but is most common in patients affected by lung cancer, breast carcinoma, melanoma or hematologic neoplasms such as lymphoma and leukemia. Controlled clinical trials are largely lacking which results in various non-standardized treatment regimens. The presence of solid tumor manifestations in the CNS as well as the extracranial tumor load defines the most appropriate treatment approach. Radiation therapy, systemic chemotherapy and intrathecal treatment must be considered. For each patient, the individual situation needs to be carefully evaluated to determine the potential benefit as well as putative side effects associated with any therapy. A moderate survival benefit and particularly relief from pain and neurological deficits are the main treatment goals. Here, we summarize the management of patients with neoplastic meningitis and review the available treatment options.
肿瘤细胞的软脑膜播散，也称为肿瘤性脑膜炎，最常见于晚期癌症患者，且大多与预后不良相关。基本上，肿瘤性脑膜炎可影响所有恶性肿瘤患者，但在肺癌、乳腺癌、黑色素瘤或血液系统肿瘤（如淋巴瘤和白血病）患者中最为常见。目前大量缺乏对照临床试验，这导致了各种非标准化的治疗方案。中枢神经系统中实体瘤表现的存在以及颅外肿瘤负荷决定了最合适的治疗方法。必须考虑放射治疗、全身化疗和鞘内治疗。对于每位患者，都需要仔细评估其个体情况，以确定任何治疗的潜在益处以及可能的副作用。适度的生存获益，尤其是缓解疼痛和神经功能缺损是主要的治疗目标。在此，我们总结了肿瘤性脑膜炎患者的管理并回顾了现有的治疗选择。
