Crizotinib Treatment Combined with Resection and Whole-brain Radiation Therapy in A ROS1 Rearranged Lung Adenocarcinoma with Brain Metastasis：Case Report and Literature Review
10.3779/j.issn.1009-3419.2016.08.07
- VernacularTitle:克唑替尼联合脑转移灶切除、全脑放疗治疗ROS1阳性伴有症状脑转移的肺腺癌1例及文献复习
- Author:
ZHANG MIN
1
,
2
,
3
;
NIE LIGONG
;
ZHANG JIAYONG
Author Information
1. 100034北京，北京大学第一医院放射治疗科
2. 100034北京，北京大学第一医院呼吸和危重症医学科
3. 100034北京，北京大学第一医院神经外科
- Keywords:
Lung neoplasms;
Crizotinib;
Brain metastasis;
Surgery;
Radiation therapy
- From:
Chinese Journal of Lung Cancer
2016;19(8):525-529
- CountryChina
- Language:Chinese
-
Abstract:
Background and objective Lung cancer with brain metastasis had poor prognosis. Crizotinib had been conifrmed to be used inROS1 (C-ros oncogene 1 receptor tyrosine kinase) rearranged lung adenocarcinoma, but its effcacy in lung cancer with brain metastasis was poor due to the blood brain barrier. In the present study, we reported one case of ROS1 fusion lung adenocarcinoma with symptomatic brain matastasis, who was treated with brain metastases resection, crizotinib, and whole brain radiotherapy plus boost to residual brain metastasis. hTe safety and effcacy was summarized.Methods At ifrst, surgical resection was used to relive mass effect and to biopsy. hTen crizotinib (250 mg,bid) was chosen for the existence ofROS1 fusion gene. Whole brain radiotherapy plus boost to residual brain metastasis were used atfer surgery. Objective re-sponse was evaluated by Response Evaluation Criteriation in Solid Tumours (RECIST) v1.1 and brain metastasis were evalu-ated by computer tomography (CT)/magnetic resonance imaging (MRI) image. Adverse events were evaluated according to Common Terminology Criteria for Adverse Events (CTC AE) v4.0.Results Atfer taking crizotinib for 3 months, the lung le-sions were close to complete response (CR), the brain metastasis were partial response (PR), the abdomen metastasis were CR and the symptom of blurred vision relieved.Conclusion Crizotinib combined with palliative operation and radiation therapy (WBRT plus boost to residual brain metastasis) in the treatment ofROS1 fusion gene positive lung adenocarcinoma with symptomatic brain metastases, can effectively control intracranial lesions with good tolerance.
