Kaneko T, Shoji A, Tsubakihara M, Okubo T, Okoshi T
First Department of Internal Medicine, Yokohama City University School of Medicine, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1995 Oct;33(10):1130-4.
A 62-year-old man was given a diagnosis of small cell lung cancer, and received 6 courses of combination chemotherapy (PE therapy) composed of cisplatin (80 mg/m2, day 1) and etoposide (100 mg/m2, days 1, 2, 3). Multiple brain metastases were found, and whole brain irradiation (44 Gy) was given. Eleven months after radiotherapy, he suffered from dizziness and abnormal gait. Enhanced CT of the head showed slight enlargement of the lateral ventricles and markedly low density of the white matter, but no evidence of intracranial tumor involvement. A magnetic resonance scan (axial T2-weighted) showed symmetric extensive hyperintensity in the white matter. Treatment-related leukoencephalopathy caused by the PE therapy and whole brain irradiation was diagnosed. He was alive 8 months after the appearance of neurological symptoms, without recurrence of lung cancer. A search of the literature revealed no previous report of leukoencephalopathy related to PE therapy.
一名62岁男性被诊断为小细胞肺癌，并接受了6个疗程的联合化疗（PE疗法），该疗法由顺铂（80mg/m²，第1天）和依托泊苷（100mg/m²，第1、2、3天）组成。发现多处脑转移后，给予全脑照射（44Gy）。放疗11个月后，他出现头晕和步态异常。头部增强CT显示侧脑室轻度扩大，白质密度明显降低，但无颅内肿瘤累及的证据。磁共振扫描（轴位T2加权）显示白质对称广泛高信号。诊断为由PE疗法和全脑照射引起的治疗相关性白质脑病。出现神经症状8个月后他仍存活，肺癌未复发。文献检索未发现先前有关与PE疗法相关的白质脑病的报道。
