Department of Radiation Oncology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Radiation Oncology Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran.
Cancer Rep (Hoboken). 2024 Apr;7(4):e2041. doi: 10.1002/cnr2.2041.
Prostate cancer is the second most common cancer in men. Central nervous system (CNS) involvement in prostate cancer which manifests as cerebral, leptomeningeal, or dural involvement is uncommon and occurs late in the course of disease.
A 60-year-old patient with castration resistant prostate cancer (CRPC) presented with headache and fatigue. Evaluation revealed bone marrow and leptomeningeal involvement. The patient treated by whole brain radiotherapy, leuprolide, weekly docetaxel and daily 1000 mg abiraterone. Complete blood count (CBC) and CNS symptoms improved and the patient is alive after 11 months with excellent performance status.
Leptomeningeal involvement in prostate cancer is rare and is associated with a poor prognosis but the possibility of such event should be considered in patients with new onset progressive CNS symptoms. New treatment strategies such as combination of docetaxel and abiraterone added to androgen deprivation therapy (triplet therapy) might improve outcome in these patients.
前列腺癌是男性第二大常见癌症。前列腺癌累及中枢神经系统（CNS），表现为脑、软脑膜或硬脑膜受累，较为少见，且通常发生在疾病晚期。
一名 60 岁去势抵抗性前列腺癌（CRPC）患者因头痛和乏力就诊。评估发现骨髓和软脑膜受累。患者接受了全脑放疗、亮丙瑞林、每周多西他赛和每日 1000mg 阿比特龙治疗。全血细胞计数（CBC）和 CNS 症状改善，患者在 11 个月后仍存活，表现状态良好。
前列腺癌累及软脑膜较为少见，且预后不良，但对于出现新发进行性 CNS 症状的患者，应考虑发生这种情况的可能性。在去势治疗的基础上联合多西他赛和阿比特龙（三联疗法）等新的治疗策略可能会改善此类患者的预后。
