Chinese Journal of Contemporary Neurology and Neurosurgery ›› 2019, Vol. 19 ›› Issue (11): 870-875. doi: 10.3969/j.issn.1672-6731.2019.11.011

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Refractory brain metastases and leptomeningeal metastases from small cell lung cancer: one case report

MA Yu-chao1, XIAO Jian-ping1, ZHANG Hong-mei2, WAN Li-juan2, LIU Shan3, LIU Ang-si4   

  1. 1 Department of Radiation Oncology, Chinese Academy of Medical Sciences and Peking Union Medical College;National Cancer Center;National Clinical Research Center for Cancer, Beijing 100021, China;
    2 Department of Radiology, Chinese Academy of Medical Sciences and Peking Union Medical College;National Cancer Center;National Clinical Research Center for Cancer, Beijing 100021, China;
    3 Department of General Treatment, Chinese Academy of Medical Sciences and Peking Union Medical College;National Cancer Center;National Clinical Research Center for Cancer, Beijing 100021, China;
    4 Department of Neurosurgery, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College;National Cancer Center;National Clinical Research Center for Cancer, Beijing 100021, China
  • Received:2019-11-14 Online:2019-11-25 Published:2019-11-25
  • Contact: XIAO Jian-ping (Email: jpxiao8@163.com)
  • Supported by:

    This study was supported by the National Science and Technology Major Project (No. 2016YFC0904603) and "Beijing Hope Run" Special Fund of Cancer Foundation of China (No. LC2014A05).

难治性小细胞肺癌脑膜转移伴脑转移瘤一例

马玉超1, 肖建平1, 张红梅2, 万丽娟2, 刘姗3, 刘昂斯4   

  1. 1. 100021 国家癌症中心 国家肿瘤临床医学研究中心 中国医学科学院 北京协和医学院肿瘤医院放射治疗科;
    2. 100021 国家癌症中心 国家肿瘤临床医学研究中心 中国医学科学院 北京协和医学院肿瘤医院放射影像诊断科;
    3. 100021 国家癌症中心 国家肿瘤临床医学研究中心 中国医学科学院 北京协和医学院肿瘤医院放射综合科;
    4. 100021 国家癌症中心 国家肿瘤临床医学研究中心 中国医学科学院 北京协和医学院肿瘤医院放射神经外科
  • 通讯作者: 肖建平,Email:jpxiao8@163.com
  • 基金资助:

    国家科技重大专项课题(项目编号:2016YFC0904603);中国癌症基金会“北京希望马拉松”专项基金资助项目(项目编号:LC2014A05)

Abstract:

Objective To summarize the diagnosis and treatment of refractory brain metastases and leptomeningeal metastases from small cell lung cancer (SCLC). Methods and Results An extensive stage SCLC male patient (44-year-old) with diffuse parenchymal meningeal metastases and large volume brain metastasis was treated with muti-disciplinary team (MDT), namely precise helical tomotherapy with concurrent temozolomide chemotherapy, combined with intrathecal chemotherapy and systemic therapy. After intracranial recurrent, intrathecal chemotherapy and radiotherapy were used to release the symptoms. At last, this patient died of extracranial disease and the survival time after the diagnosis of brain metastases was 16 months. Conclusions For treatment of brain or leptomeningeal metastases, comprehensive and individualized treatment are needed, and MDT treatment discussion is highly recommended.

Key words: Small cell lung carcinoma, Neoplasm metastasis, Meningeal neoplasms, Brain neoplasms, Radiotherapy, Antineoplastic combined chemotherapy protocols

摘要:

目的 报告1例难治性小细胞肺癌脑膜转移伴脑转移瘤患者的诊断与治疗经过。方法与结果 1例44岁男性广泛期小细胞肺癌患者,经根治性放射治疗、药物化疗和预防性脑照射后1年6个月出现脑膜转移伴脑转移,采取多学科诊疗模式即螺旋断层放射治疗联合替莫唑胺同步化疗、甲氨蝶呤+地塞米松鞘内注射化疗和全身系统性治疗,脑转移后生存期为16个月,死于颅外病变进展。结论 对于难治性小细胞肺癌脑和(或)脑膜转移患者,应积极采取多学科诊疗模式,合理应用多种治疗方法、兼顾综合治疗与个体化治疗。

关键词: 小细胞肺癌, 肿瘤转移, 脑膜肿瘤, 脑肿瘤, 放射疗法, 抗肿瘤联合化疗方案