Tanaka Hiroaki, Inomata Minehiko, Hayashi Ryuji, Shimokawa Kazuki, Tokui Kotaro, Okazawa Seisuke, Kambara Kenta, Yamada Toru, Miwa Toshiro, Kashii Tatsuhiko, Konishi Hirofumi, Tobe Kazuyuki
First Dept. of Internal Medicine, Toyama University Hospital.
Gan To Kagaku Ryoho. 2017 Jul;44(7):595-597.
A 65-year-old man was diagnosed with leptomeningeal carcinomatosis based on the findings of cerebrospinal fluid cytology and magnetic resonance imaging(MRI).Treatment with erlotinib and bevacizumab was initiated, and partial improvement in consciousness and MRI findings were obtained.However, it was difficult to continue the treatment because of elevation in levels of liver enzymes and melena.We switched the treatment to afatinib monotherapy, and his consciousness improved immediately.Progression -free survival and overall survival from the initiation of the treatment with afatinib were 7 and 9.4 months, respectively. This clinical course suggests activity of afatinib for central nervous system lesions of EGFRmutated lung cancer.
一名65岁男性根据脑脊液细胞学检查和磁共振成像（MRI）结果被诊断为软脑膜癌病。开始使用厄洛替尼和贝伐单抗进行治疗，意识和MRI表现得到部分改善。然而，由于肝酶水平升高和黑便，难以继续该治疗。我们将治疗改为阿法替尼单药治疗，他的意识立即得到改善。从开始使用阿法替尼治疗起，无进展生存期和总生存期分别为7个月和9.4个月。这一临床过程提示阿法替尼对EGFR突变型肺癌的中枢神经系统病变具有活性。
