Analysis of Clinicopathological Feature and Prognosis for Leptomeningeal Metastasis in Non-small Cell Lung Cancer
- VernacularTitle:非小细胞肺癌脑膜转移的临床病理特征及预后分析
- Author:
ZHU MIN
1
;
REN YANHONG
;
LIU YAN
;
BAN CHENGJUN
;
GU HUA
;
WANG ZHENG
;
ZHANG YUHUI
Author Information
1. 首都医科大学附属北京朝阳医院呼吸与危重症医学科
- Keywords:
Lung neoplasms;
EGFR mutation;
Leptomeningeal metastasis
- From:
Chinese Journal of Lung Cancer
2016;19(8):533-538
- CountryChina
- Language:Chinese
-
Abstract:
Background and objectiveLeptomeningeal metastases (LM) is one of the most serious complications of advanced non-small cell lung cancer (NSCLC) due to the lower quality of life and poor prognosis. hTe aim of this study is to analyze the clinicopathological features and prognosis of patients with LM from NSCLC (NSCLC-LM).MethodsClinical data of 3 patients with NSCLC-LM collected from January 2015 to June 2016 were analyzed with a brief review.Results All 3 patients had adenocarcinoma histology harboring epidermal growth factor receptor (EGFR) exon 21 point mutations (m). Of the 3 cases, 1 was male, 2 were female. hTe mean age was 61.3 years (range, 59-64 years). hTe main clinical manifestations and positive physical examination included headache (3/3), dizziness (3/3), nausea (3/3) and vomiting (3/3), epilepsy (2/3), diplopia (1/3), hearing loss (1/3) and meningeal stimulation sign (3/3). hTe median time from symptom to diagnosis of LM was 2.3 months (range, 1 to 4 months). Except 1 patient with lung cancer and LM diagnosised at the same time, the other 2 cases received the diagnosis of LM atfer tyrosine kinase inhibitors (TKIs) therapy or chemotherapy respectively, the median time from diagnosis of NSCLC to LC was 8.5 months. hTe brain enhanced magnetic resonance imaging (MRI) manifestations of all 3 cases revealed linear meningeal enhancement. Cerebrospinal lfuid in 3 cases were positive cytology in whom two cases had EGFR exon 21 L858R mutations, consistenting with the lung tissue. hTe symptom of the 2 cases improved atfer TKIs ther-apy, and temozolomide was used as supplement of 1 case of which the progression-free survival (PFS) and overall survival (OS) was 4.9 months and 13.9 months respectively.ConclusionLung adenocarcinoma with sensitiveEGFR mutations are likely to appear LM. Lacking of typical symptoms, NSCLC-LM was easily to be missed and misdiagnosed. TKIs therapy combined with temozolomide may be effective therapies for EGFRm-NSCLC-LM patients.
