EGFR突变的非小细胞肺癌软脑膜转移治疗进展

Progress in Treatment of Leptomeningeal Metastasis in Non-Small Cell Lung Cancer with Epidermal Growth Factor Receptor Mutations

软脑膜转移(LM)是非小细胞肺癌(NSCLC)最严重的并发症之一,其预后极差。LM的早期发现和诊断在临床工作面临巨大挑战。随着NSCLC诊治的进展,尤其是靶向药物的出现,LM的发病率逐年升高。目前,对于LM尚无统一有效治疗手段和最佳临床管理,传统治疗方法(放疗、化疗、手术治疗和鞘内注射化疗)疗效不理想,而酪氨酸激酶抑制剂具有较好的抗肿瘤活性,其在表皮生长因子受体(EGFR)敏感突变NSCLC-LM患者中具有良好的应用前景。未来,应进一步提高对EGFR敏感突变NSCLC-LM的认识和规范化诊疗,以为临床提供最佳治疗策略。

Leptomeningeal metastasis(LM)is one of the most serious complications of non-small-cell lung cancer(NSCLC),and its prognosis is very poor.Early detection and diagnosis of LM is facing great challenges in the clinical practice.With the progress of diagnosis and treatment of NSCLC,especially the emergence of targeted drugs,the incidence of LM is increasing year by year.At present,there is no universally effective medical treatment and optimal clinical management for LM.Traditional treatment methods(radiotherapy,chemotherapy,surgical treatment and intrathecal injection chemotherapy)do not have ideal effect.Tyrosine kinase inhibitors have good anti-tumor activity,and it has good application prospects in NSCLC-LM patients with epidermal growth factor receptor(EGFR)sensitive mutation.In the Future,we should further improve the understanding and standardization of diagnosis and treatment of NSCLC-LM with EGFR sensitive mutation,in order to provide the best treatment strategy in the clinical practice.