Chonan Masashi, Narita Norio, Tominaga Teiji
Department of Neurosurgery, Iwaki Kyoritsu Hospital, 16 Kusehara, Uchigo Mimaya-machi, Iwaki, Fukushima, 973-8555, Japan.
Department of Neurosurgery, Kesennuma City Hospital, Kesennuma, Miyagi, Japan.
BMC Res Notes. 2016 Jan 2;9:2. doi: 10.1186/s13104-015-1834-0.
Gefitinib is an epidermal growth factor receptor tyrosine kinase inhibitor. Clinical trials have reported its effectiveness in the treatment of brain metastases from non-small cell lung cancer by overcoming the blood-brain barrier. Gefitinib is generally regarded as a relatively safe agent, and several reports have described its efficacy in patients with epidermal growth factor receptor mutation-positive non-small cell lung cancer and a poor performance status.
We herein described two patients with brain metastasis from non-small cell lung cancer who achieved the total regression of metastasis with the administration of gefitinib. A 70-year-old Japanese woman was referred to our hospital with a severe cough. Brain magnetic resonance imaging revealed a metastatic lesion in the left temporal lobe. The tumor was positive for an epidermal growth factor receptor L858R mutation in exon 21 using the peptide nucleic acid-locked nucleic acid polymerase chain reaction clamp method. She was treated with 250 mg gefitinib per day, and, 1 month later, the primary lesion and brain metastasis had totally resolved. A 58-year-old Japanese woman was referred to our hospital with nausea and headache. Brain magnetic resonance imaging revealed a metastatic lesion in the left cerebellar hemisphere and meningeal dissemination. The tumor was positive for the epidermal growth factor receptor L858R mutation in exon 21. She was treated with 250 mg gefitinib per day, and, 3 weeks later, the primary lesion, brain metastasis, and meningeal dissemination had completely resolved.
We successfully treated two lung cancer patients with brain metastasis using gefitinib. Gefitinib therapy may be a suitable treatment for brain metastasis in lung cancer with an epidermal growth factor receptor mutation, particularly in elderly patients with a poor performance status.
吉非替尼是一种表皮生长因子受体酪氨酸激酶抑制剂。临床试验报告了其通过克服血脑屏障治疗非小细胞肺癌脑转移的有效性。吉非替尼通常被认为是一种相对安全的药物，并且有几份报告描述了其在表皮生长因子受体突变阳性且体能状态较差的非小细胞肺癌患者中的疗效。
我们在此描述了两名非小细胞肺癌脑转移患者，他们通过服用吉非替尼实现了转移灶的完全消退。一名70岁的日本女性因严重咳嗽被转诊至我院。脑部磁共振成像显示左侧颞叶有一个转移病灶。使用肽核酸-锁核酸聚合酶链反应钳夹法检测，肿瘤的第21外显子表皮生长因子受体L858R突变呈阳性。她每天服用250毫克吉非替尼，1个月后，原发灶和脑转移灶完全消退。一名58岁的日本女性因恶心和头痛被转诊至我院。脑部磁共振成像显示左侧小脑半球有一个转移病灶和脑膜播散。肿瘤的第21外显子表皮生长因子受体L858R突变呈阳性。她每天服用250毫克吉非替尼，3周后，原发灶、脑转移灶和脑膜播散完全消退。
我们使用吉非替尼成功治疗了两名肺癌脑转移患者。吉非替尼治疗可能是表皮生长因子受体突变的肺癌脑转移的合适治疗方法，特别是对于体能状态较差 的老年患者。
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