Department of Neurosurgery, Tianjin TEDA Hospital, Tianjin, China (mainland).
Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China (mainland).
Med Sci Monit. 2019 Aug 30;25:6504-6511. doi: 10.12659/MSM.915470.
BACKGROUND Lung cancer with intracranial metastasis requires concurrent treatment of the primary lung tumor and the secondary brain tumor. This study aimed to investigate the short-term clinical efficacy of concurrent bronchial artery and posterior inferior cerebellar artery microcatheter interventional chemotherapy for the treatment of adenocarcinoma of the lung with solitary cerebellar metastasis. MATERIAL AND METHODS Seventeen patients with adenocarcinoma of the lung with solitary cerebellar metastasis received concurrent microcatheter interventional chemotherapy via the bronchial artery and posterior inferior cerebellar artery. Two cycles of treatment with teniposide (VM-26), carmustine (BCNU), carboplatin (CBP), and pirarubicin (THP) were performed every four weeks. RESULTS Four patients (23.53%) achieved a complete response (CR), five patients (29.41%) achieved a partial response (PR), seven patients (41.18%) had stable disease (SD), and only one patient (5.88%) developed progressive disease (PD). The objective response rate (ORR) and disease control rate (DCR) were 52.94% (9/17) and 94.12% (16/17), respectively. Four patients (11.76%) developed grade 1/2 chemotherapy toxicity, which included three cases (8.82%) of gastrointestinal toxicity and one case (2.84%) of granulocytopenia, but no grade 3/4 toxicity was found. During microcatheter interventional chemotherapy, three patients (8.82%) developed intracranial complications, including two cases (5.88%) of cerebrovascular spasm and one case (2.94%) of cerebral edema. CONCLUSIONS In 17 patients with adenocarcinoma of the lung with solitary cerebellar metastasis, concurrent microcatheter interventional chemotherapy via the bronchial artery and posterior inferior cerebellar artery was safe and showed short-term efficacy.
肺癌合并颅内转移需要同时治疗肺部原发肿瘤和颅内继发肿瘤。本研究旨在探讨同期支气管动脉和小脑后下动脉微导管介入化疗治疗孤立性小脑转移腺癌的短期临床疗效。
17 例孤立性小脑转移腺癌患者接受同期支气管动脉和小脑后下动脉微导管介入化疗。每 4 周进行 2 个周期的依托泊苷(VM-26)、卡莫司汀(BCNU)、卡铂(CBP)和吡柔比星(THP)治疗。
4 例(23.53%)患者完全缓解(CR),5 例(29.41%)患者部分缓解(PR),7 例(41.18%)患者病情稳定(SD),仅 1 例(5.88%)患者疾病进展(PD)。客观缓解率(ORR)和疾病控制率(DCR)分别为 52.94%(9/17)和 94.12%(16/17)。4 例(11.76%)患者出现 1/2 级化疗毒性,包括 3 例(8.82%)胃肠道毒性和 1 例(2.84%)粒细胞减少,但未发现 3/4 级毒性。在微导管介入化疗过程中,3 例(8.82%)患者出现颅内并发症,包括 2 例(5.88%)脑血管痉挛和 1 例(2.94%)脑水肿。
17 例孤立性小脑转移腺癌患者同期支气管动脉和小脑后下动脉微导管介入化疗安全有效。