Chamberlain M C, Kormanik P A
University of California, San Diego, USA.
Arch Neurol. 1997 Nov;54(11):1364-8. doi: 10.1001/archneur.1997.00550230037013.
To assess the clinical significance of bulky metastatic central nervous system disease in patients with leptomeningeal metastases.
Forty patients (24 women and 16 men) ranging in age from 32 to 74 years (median, 56.5 years) with cytologically documented leptomeningeal metastases were demonstrated by cranial or spinal magnetic resonance imaging to have either no bulky central nervous system metastatic disease (group A; 20 patients) or bulky central nervous system metastatic disease (group B; 20 patients). Twenty-nine patients were treated with involved-field radiotherapy, and all patients were treated with sequential intraventricular chemotherapy.
Median survival was 7 months in group A (range, 5-12 months) as compared with 4 months in group B (range, 2-12 months) (P < .01; Mantel-Cox log rank analysis). Cause of death was similar in both patient groups.
In patients with leptomeningeal metastases, neuroradiographic demonstration of bulky metastatic central nervous system disease independently predicts survival and is useful in determining which patients are candidates for intraventricular chemotherapy.
评估软脑膜转移患者中枢神经系统大块转移性疾病的临床意义。
40例患者（24例女性和16例男性），年龄32至74岁（中位年龄56.5岁），经细胞学证实有软脑膜转移，通过头颅或脊髓磁共振成像显示，其中20例患者无中枢神经系统大块转移性疾病（A组），20例患者有中枢神经系统大块转移性疾病（B组）。29例患者接受了累及野放疗，所有患者均接受了序贯脑室内化疗。
A组中位生存期为7个月（范围5至12个月），而B组为4个月（范围2至12个月）（P <.01；Mantel-Cox对数秩分析）。两组患者的死亡原因相似。
在软脑膜转移患者中，中枢神经系统大块转移性疾病的神经影像学表现可独立预测生存期，有助于确定哪些患者适合接受脑室内化疗。
