Efficacy of a lumbo-peritoneal shunt for meningeal carcinomatosis refractory to gefitinib treatment.
Efficacy of a lumbo-peritoneal shunt for meningeal carcinomatosis refractory to gefitinib treatment.
复制标题
腰腹膜分流术治疗吉非替尼治疗难治性脑膜癌病的疗效。
作者：
T. Kubo;N. Takigawa;K. Kiura;A. Nishida;N. Ochi;H. Kashihara;S. Umemura;A. Hisamoto;M. Tanimoto
1例51岁女性患者出现左面神经麻痹。她患有肺腺癌，并伴有多发性脑转移。原发肿瘤经吉非替尼治疗后消退，但由于脑膜癌病，当从她的脑脊液细胞中检测到表皮生长因子受体外显子19的缺失突变时，神经症状迅速恶化。在进行了腰-腹膜分流术后，她的症状显著改善，15个月来一直没有腹膜扩散，继续接受吉非替尼治疗。最后，她在腰-腹膜分流术18个月后死亡。尸检时，在其肠系膜淋巴结和脑脊液中发现了表皮生长因子受体第20外显子的T790M获得性抗性突变。对于对Gefitinib治疗无效且未出现T790M突变的脑膜癌病，可考虑采用腰-腹膜分流术。
A 51-year-old female presented with left facial palsy. She had adenocarcinoma of the lung with multiple brain metastases. The primary tumor regressed after treatment with gefitinib, however, neurological symptoms progressed rapidly because of meningeal carcinomatosis, when a deletion mutation in exon 19 of the epidermal growth factor receptor in cells from her cerebrospinal fluid was detected. After performing lumbo-peritoneal shunting, her symptoms improved dramatically and she had been well without peritoneal dissemination for 15 months, continuing gefitinib treatment. Finally, she died 18 months after lumbo-peritoneal shunting. A T790M acquired-resistance mutation in exon 20 of the epidermal growth factor receptor was found from her mesenteric lymph nodes and cerebrospinal fluid at autopsy. A lumbo-peritoneal shunt might be considered for meningeal carcinomatosis refractory to gefitinib treatment without an emergence of a T790M mutation.
影响因子：
158.5
作者：
Kobayashi, S;Boggon, TJ;Halmos, B
通讯作者：
Halmos, B
影响因子：
45.3
作者：
Jackman, David M.;Holmes, Alison J.;Johnson, Bruce E.
通讯作者：
Johnson, Bruce E.