非小细胞肺癌脑膜转移诊疗现状

Diagnosis and Treatment of Leptomeningeal Metastasis in Non-small Cell Lung Cancer

脑膜转移(leptomeningeal metastasis,LM)是非小细胞肺癌(non-small cell lung cancer,NSCLC)的一个灾难性事件,患者临床症状重,预后极差。尽管鞘内注射化疗在晚期NSCLC的LM患者中显示一定的疗效,NSCLCLM生存期仍仅为12周-14周。肺腺癌是NSCLC-LM患者主要的病理类型(84%-97%)。其中43.0%-70.5%的NSCLCLM患者检测到表皮生长因子受体(epidermal growth factor receptor,EGFR)敏感突变。研究表明,经选择的患者应用EGFR酪氨酸激酶抑制剂(tyrosine kinase inhibitors,TKIs)治疗LM有效,可延长生存期。未来需要进一步的临床试验来验证EGFR-TKIs治疗的NSCLC-LM患者的疗效。

Leptomeningeal metastasis （LM） is one of the disastrous events in managing advanced non-small cell lung cancer （NSCLC） due to severe clinical symptoms and a grave prognosis. Although intrathecal （IT） chemotherapy show some effects for LM in advanced NSCLC, the prognosis is stiU poor （12 wk-14 wk）. A large majority （84%-97%） of the patients were found to have adenocarcinoma histology. Epidermal growth factor receptor （EGFR） senstive mutations were detected in 43.0%-70.5% adenocarcinoma patients with LM. EGFR tyrosine kinase inhibitors （TKIs） showed to be effective for LM in se- lected NSCLC patients in some reseaches, and confer a survival benefit. Furthermore, future trials need be done to determine the effect of EGFR-TKIs treatment in NSCLC-LM patients.