Capecitabine therapy of central nervous system metastases from breast cancer
Capecitabine therapy of central nervous system metastases from breast cancer
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DOI：
10.1007/s11060-007-9409-0
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发表时间：
2007-11-01
影响因子：
3.9
通讯作者：
Abrey, Lauren E.
中科院分区：
文献类型：
--
作者：
Ekenel, Meltem;Hormigo, Adilia M.;Abrey, Lauren E.
乳腺癌的中枢神经系统（CNS）转移预后不良。由于血脑屏障（BBB）的不通透性和中枢神经系统转移固有的化疗耐药性，全身化疗通常无效。支持在这种情况下使用卡培他滨的数据有限。回顾了 1994 年至 2006 年在纪念斯隆-凯特琳癌症中心接受卡培他滨治疗的 7 名乳腺癌脑转移患者的医疗记录。对这些患者的治疗结果进行回顾性分析。从乳腺癌诊断到发生中枢神经系统转移的中位时间为 48 (18-165) 个月。 4 名患者仅存在脑转移，2 名患者同时存在软脑膜和脑转移，1 名患者仅存在软脑膜转移。七分之五的患者在卡培他滨之前接受其他治疗均失败。卡培他滨治疗后，三名患者表现出完全缓解（CR），三名患者疾病稳定（SD）。患有软脑膜疾病的患者临床有所改善，但拒绝重复脑脊液 (CSF) 研究。所有患者自开始使用卡培他滨起的中位总生存期和无进展生存期分别为 13 个月和 8 个月。卡培他滨可以实现 CR，并为乳腺癌软脑膜和实质 CNS 转移患者提供长期控制。
Central nervous system (CNS) metastases from breast cancer carry a poor prognosis. Systemic chemotherapy is often ineffective due to the impermeability of the blood-brain barrier (BBB) and inherent chemoresistance of CNS metastases. There are limited data supporting the use of capecitabine in this setting. Medical records of seven patients with brain metastases from breast cancer who received capecitabine treatment at Memorial Sloan-Kettering Cancer Center from 1994-2006 were reviewed. Treatment outcomes were analyzed retrospectively in those patients. Median time from breast cancer diagnosis to the development of CNS metastasis was 48 (18-165) months. Four patients had brain metastases alone, two patients had both leptomeningeal and brain metastases and one patient had leptomeningeal metastasis alone. Five out of seven patients had failed other treatment modalities before capecitabine. Three patients showed complete response (CR) and three patients had stable disease (SD) after capecitabine. The patient with leptomeningeal disease improved clinically, but refused repeat cerebrospinal fluid (CSF) studies. Median overall and progression-free survival from initiation of capecitabine was 13 and 8 months, respectively, for all patients. Capecitabine may achieve a CR and provide long-term control in patients with both leptomeningeal and parenchymal CNS metastases from breast cancer.