Palliative cerebrospinal fluid shunting for leptomeningeal metastasis-related hydrocephalus in patients with lung adenocarcinoma: A single-center retrospective study
Palliative cerebrospinal fluid shunting for leptomeningeal metastasis-related hydrocephalus in patients with lung adenocarcinoma: A single-center retrospective study
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DOI：
10.1371/journal.pone.0210074
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发表时间：
2019-01-10
期刊：
影响因子：
3.7
通讯作者：
Harada, Hideyuki
中科院分区：
文献类型：
--
作者：
Mitsuya, Koichi;Nakasu, Yoko;Harada, Hideyuki
目的软脑膜转移相关脑积水 (LM-H) 的治疗在控制颅内高压引起的严重头痛、恶心和呕吐方面尤其具有挑战性。探讨脑脊液分流术治疗肺腺癌LM-H患者的体能状况和预后的改善情况。方法回顾性分析经MR成像和/或细胞学检查确诊的肺腺癌软脑膜转移相关性脑积水患者的资料。 2008 年 8 月至 2017 年 7 月期间，作者回顾了 31 名需要脑脊液分流术的患者，他们接受了脑室-腹膜或腰腹膜分流术。结果患者包括 11 名男性和 20 名女性，中位年龄为 59 岁。 26 名患者接受了 EGFR 酪氨酸激酶抑制剂 (TKI) 治疗。脑脊液分流手术使 90.3% 的患者的体能状态迅速改善。 ECOG 体能状态低于 2 的患者从诊断为 LM 起的中位总生存期为 7.7 个月，明显长于 PS 3 或 4 的患者（4.4 或 1.5 个月；p
PurposeManagement of leptomeningeal metastasis-related hydrocephalus (LM-H) is particularly challenging regarding the control of severe headache, nausea, and vomiting due to intracranial hypertension. To investigate the improvements of performance status and outcome with cerebrospinal fluid (CSF) shunt surgery for LM-H in patients with lung adenocarcinoma.MethodsData on patients with leptomeningeal metastasis-related hydrocephalus from lung adenocarcinoma diagnosed by MR imaging and/or cytological examination were retrospectively analyzed. Between August 2008 and July 2017, the authors reviewed 31 patients requiring CSF shunt, who underwent ventriculo-peritoneal or lumbo-peritoneal shunt.ResultsThe patients consisted of 11 men and 20 women with a median age of 59 years. Twenty-six patients received EGFR-tyrosine kinase inhibitors (TKIs). CSF shunt surgery yielded rapid improvement in the performance status of 90.3% of patients. Median overall survival from the diagnosis of LM in patients with ECOG performance status less than 2 was 7.7 months, and this was significantly longer than those in patients with PS 3 or 4 (4.4 or 1.5 months; p