Yoshioka Hiromasa, Okuda Takeshi, Nakao Takayuki, Fujita Mitsugu, Takahashi Jun C
Department of Neurosurgery, Kindai University Faculty of Medicine, 377-2 Ohno-Higashi, Osaka-Sayama, Osaka, 589-8511 Japan.
Department of Microbiology, Kindai University Faculty of Medicine, Osaka-Sayama, Osaka, Japan.
Int Cancer Conf J. 2021 Jun 5;10(4):290-293. doi: 10.1007/s13691-021-00491-1. eCollection 2021 Oct.
We report that tirabrutinib was administered via nasogastric tubes to treat an elderly patient with primary central nervous system lymphoma (PCNSL). The patient was a 76-year-old woman who underwent endoscopic biopsy of multiple intracerebral masses, which resulted in the diagnosis of diffuse large B-cell lymphoma. The patient was diagnosed with PCNSL and was started on an induction regimen of systemic chemotherapy with rituximab in combination with high-dose methotrexate. However, after the second cycle of chemotherapy, the tumor grew rapidly, and the patient went into a coma. As a result, the treatment was changed to nasogastric tube administration of tirabrutinib suspension. After 1 week of tirabrutinib administration, the patient's level of consciousness improved, and furthermore, after 2 weeks of tirabrutinib administration, the patient was able to take tirabrutinib orally. Although oral administration is the standard route of administration for tirabrutinib, this case study showed that the nasogastric tube administration of tirabrutinib suspension is a therapeutic option for patients with impaired consciousness or dysphagia.
我们报告了通过鼻胃管给予替拉鲁替尼治疗一名老年原发性中枢神经系统淋巴瘤（PCNSL）患者的情况。该患者为一名76岁女性，接受了多次脑内肿块的内镜活检，诊断为弥漫性大B细胞淋巴瘤。该患者被诊断为PCNSL，并开始接受利妥昔单抗联合大剂量甲氨蝶呤的全身化疗诱导方案。然而，在化疗的第二个周期后，肿瘤迅速生长，患者陷入昏迷。因此，治疗改为通过鼻胃管给予替拉鲁替尼混悬液。在给予替拉鲁替尼1周后，患者的意识水平有所改善，此外，在给予替拉鲁替尼2周后，患者能够口服替拉鲁替尼。尽管口服给药是替拉鲁替尼的标准给药途径，但本病例研究表明，通过鼻胃管给予替拉鲁替尼混悬液是意识障碍或吞咽困难患者的一种治疗选择。
