Treatment of intracranial metastatic esthesioneuroblastoma
Treatment of intracranial metastatic esthesioneuroblastoma
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DOI：
10.1002/cncr.10679
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发表时间：
2002-07-15
期刊：
影响因子：
6.2
通讯作者：
Chamberlain, MC
中科院分区：
文献类型：
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作者：
Chamberlain, MC
背景资料。摘要嗅觉神经母细胞瘤是一种罕见的肿瘤，可转移至中枢神经系统。据作者所知，目前还没有关于治疗的共识。方法6例(男2例，女4例)脑转移患者，年龄47~61岁(中位年龄53.5岁)，均有中枢神经系统转移的临床和神经放射学证据(脑实质转移6例，软脑膜转移3例)。中枢神经系统定向治疗包括放射治疗(3名患者接受脑部治疗，2名患者接受脊柱治疗)和化疗(6名患者接受全身治疗，3名患者接受局部治疗)。全身化疗由卡铂、洛莫司汀和长春新碱组成，每2个月给药一次。每隔一个月对患者进行一次神经放射学检查和神经功能检查。结果共进行了1~6个周期的全身化疗，中位数为4.5个周期。区域化疗6~19个周期(中位数17个周期)。毒性包括无菌性脑膜炎(3例)、放射性肠炎(1例)和大于或等于3级(根据国家癌症研究所共同毒性标准)的骨髓抑制(4例)。两名患者因中性粒细胞减少症住院，两名患者需要输血(两名患者使用血小板，一名患者使用红细胞)。没有与治疗相关的死亡报告。4名患者部分缓解，2名患者病情进展。中位有效时间为9个月(2~12个月)。总生存期3~13个月，中位生存期10.5个月。死亡原因为进展性脑实质疾病3例，全身性疾病2例，软脑膜病1例。结论：在本研究的小群患者中，综合治疗被发现有适度的毒性和姑息性疗效。(C)2002年美国癌症协会。
BACKGROUND. Esthesioneuroblastoma (ENB) is an uncommon tumor that may metastasize to the central nervous system (CNS). To the authors' knowledge there is no current consensus regarding treatment. The current study was conducted to determine the toxicity and response rate of combined modality therapy in the treatment of patients with ENB metastatic to the brain.METHODS. Six patients (2 men and 4 women) ranging in age from 47-61 years (median age, 53.5 years) with ENB had clinical and neuroradiographic evidence of CNS metastases (brain parenchyma in 6 patients and leptomeningeal metastases in 3 patients). CNS-directed therapy included radiotherapy (to the brain in three patients and to the spine in two patients) and chemotherapy (systemic in six patients and regional in three patients). Systemic chemotherapy was comprised of carboplatin, lomustine, and vincristine administered every 2 months. Patients were evaluated by neuroradiographic and neurologic examination every other month.RESULTS. Between 1-6 cycles of systemic chemotherapy were administered (median, 4.5 cycles). and 6-19 cycles of regional chemotherapy were administered (median, 17 cycles). Toxicity included aseptic meningitis (three patients), radiation enteritis (one patient), and greater than or equal to Grade 3 (according to the National Cancer Institute Common toxicity Criteria) myelosuppression (four patients). Two patients required hospitalization for neutropenic fever and two patients required a transfusion (platelets-in two patients and red blood cells in one patient). No treatment-related deaths were reported. A partial response was achieved in four patients, and two patients demonstrated progressive disease. The median duration of response was 9 months (range, 2-12 months). Overall survival ranged from 3-13 months (median, 10.5 months). The cause of death was progressive parenchymal brain disease in three patients, systemic disease in two patients, and leptomeningeal disease in one patient.CONCLUSIONS. In the small cohort of patients in the current study, combined modality therapy was found to have modest toxicity and palliative efficacy. (C) 2002 American Cancer Society.