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[非小细胞肺癌软脑膜转移的诊断与治疗]

[Diagnosis and Treatment of Leptomeningeal Metastasis in Non-small Cell Lung Cancer].

作者信息

Xu Yan, Li Longyun, Wang Mengzhao

机构信息

Department of Respiratory Disease, Peking Union Medical College Hospital, Chinese Academy of Medical Science 
& Peking Union Medical College, Beijing 100730, China.

出版信息

Zhongguo Fei Ai Za Zhi. 2015 Oct 20;18(10):626-32. doi: 10.3779/j.issn.1009-3419.2015.10.05.

Abstract

Leptomeningeal metastasis (LM) is one of the disastrous events in managing advanced non-small cell lung cancer (NSCLC) due to severe clinical symptoms and a grave prognosis. Although intrathecal (IT) chemotherapy show some effects for LM in advanced NSCLC, the prognosis is still poor (12 wk-14 wk). A large majority (84%-97%) of the patients were found to have adenocarcinoma histology. Epidermal growth factor receptor (EGFR) senstive mutations were detected in 43.0%-70.5% adenocarcinoma patients with LM. EGFR tyrosine kinase inhibitors (TKIs) showed to be effective for LM in selected NSCLC patients in some reseaches, and confer a survival benefit. Furthermore, future trials need be done to determine the effect of EGFR-TKIs treatment in NSCLC-LM patients.

摘要

软脑膜转移(LM)是晚期非小细胞肺癌(NSCLC)治疗中灾难性事件之一,因其临床症状严重且预后不良。尽管鞘内(IT)化疗对晚期NSCLC的LM有一定疗效,但预后仍较差(12周 - 14周)。绝大多数(84% - 97%)患者为腺癌组织学类型。在43.0% - 70.5%的LM腺癌患者中检测到表皮生长因子受体(EGFR)敏感突变。在一些研究中,EGFR酪氨酸激酶抑制剂(TKIs)对部分NSCLC患者的LM显示出疗效,并带来生存获益。此外,未来需要开展试验以确定EGFR - TKIs治疗对NSCLC - LM患者的效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8af0/6000085/7f81beffcd47/zgfazz-18-10-626-1.jpg

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