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뇌실질 전이가 있는 비소세포성 폐암 환자에서의 연수막 전이 빈도 및 예후 인자

Other Titles
 Incidence and Prognostic Factors of Leptomeningeal Metastasis from Non-Small Cell Lung Cancer 
Authors
 나영철  ;  김지희  ;  김창환  ;  장원석  ;  장진우  ;  박용구 
Citation
 Journal of Korean Brain Tumor Society (대한뇌종양학회지), Vol.11(2) : 102-107, 2012 
Journal Title
 Journal of Korean Brain Tumor Society  (대한뇌종양학회지) 
ISSN
 1598-530x 
Issue Date
2012
Abstract
Objectives: The object of this study is to evaluate the incidence, survival and the prognostic factors in patients with leptomeningeal metastasis from non-small cell lung cancer. Methods: The study included fifty-five consecutive patients diagnosed with brain parenchymal metastasis on magnetic resonance image (MRI) clinically from non-small cell lung cancer between July 2010 and February 2011. All the patients underwent lumbar puncture for cerebrospinal fluid examination including cytology examination with cytokeratine immunostain. If the patients showed positive in cerebrospinal cytology or leptomeningeal enhancement on T1 weighted gadolinium enhanced MRI, whole spine MRI with gadolinium enhancement was also taken for evaluation of spinal disease. For evaluation of prognostic factors, we investigated the patient’s age, interval from the time of diagnosis of systemic disease to the time of diagnosis of leptomeningeal metastasis, interval from the time of diagnosis of parenchymal metastasis to the time of diagnosis of leptomeningeal metastasis, performance status of the patients, and following treatment modality after diagnosis of leptomeningeal metastasis. Result: In eleven (20%) of the fifty-five patients, the diagnosis of leptomeningeal metastasis was made on the basis of MRI findings and the results from cerebrospinal fluid cytology. Among those eleven patients, eight (72.7%) had positive cerebrospinal fluid cytology at the time of initial examination. Eight of the eleven patients underwent an operation for intraventricular catheter and reservoir placement in order to receive intraventricular chemotherapy. In six (75%) of the eight intraventricular chemotherapy patients, the negative conversion of cerebrospinal fluid cytology was achieved during induction chemotherapy of four weeks. The overall median survival for the eleven patients after the diagnosis of leptomeningeal metastasis and the eight subsequent intraventricular chemotherapy patients was 62 days (95% confidence interval 27.4-96.6). The most possible prognostic factor was the intervals from primary disease to leptomeningeal metastasis (p=0.071). Conclusion: In this study, we found that relatively high proportion of the patients of non-small cell lung cancer with parenchymal metastases were co-morbided by leptomeningeal metastases, and revealed that the interval from primary disease to leptomeningeal metastasis could be an important factor for survival. However, further well-designed investigations, with larger sample sizes, must be conducted to evaluate other prognostic factors as well as new drugs, and to define the optimal treatment combinations and route.
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/92248
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실)
Yonsei Authors
김지희(Kim, Ji Hee) ; 김창환(Kim, Chang Hwan) ; 박용구(Park, Yong Gou) ; 장원석(Chang, Won Seok) ; 장진우(Chang, Jin Woo)
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