【摘要】：目的 :探討腦室腹腔分流手術(shù)治療惡性顱內(nèi)高壓為初發(fā)癥狀的肺腺癌腦膜轉(zhuǎn)移的臨床效果。方法 :回顧性分析本院收治的21例表皮生長因子受體(epidermal growth factor receptor,EGFR)基因突變的肺腺癌腦膜轉(zhuǎn)移患者的臨床資料,根據(jù)治療方案將患者分為觀察組(吉非替尼聯(lián)合腦室腹腔分流組11例)和對照組(吉非替尼組10例),對2組的治療效果進行比較。結(jié)果 :觀察組的腦脊液癌細胞轉(zhuǎn)陰率為63.6%,對照組的腦脊液癌細胞轉(zhuǎn)陰率為40.0%,兩組比較差異無統(tǒng)計學意義(P0.05);觀察組癥狀緩解率為90.9%,對照組癥狀緩解率為40.0%,兩組比較差異有統(tǒng)計學意義(P0.05);觀察組的中位無進展生存期為7.8個月,對照組中位無進展生存期為5.3個月,兩組比較差異有統(tǒng)計學意義(P=0.014)。結(jié)論 :以惡性顱內(nèi)高壓為初發(fā)癥狀的EGFR基因突變的肺腺癌腦膜轉(zhuǎn)移患者接受吉非替尼聯(lián)合腦室腹腔分流取得了較好的治療效果,有望成為EGFR基因突變的肺腺癌腦膜轉(zhuǎn)移患者的治療方案。
[Abstract]:Objective: to investigate the clinical effect of intraventricular and peritoneal shunt in the treatment of meningeal metastasis of lung adenocarcinoma with malignant intracranial hypertension. Methods: the clinical data of 21 patients with meningeal metastasis with epidermal growth factor receptor (epidermal growth factor receptor,EGFR) gene mutation were retrospectively analyzed. Patients were divided into observation group (11 cases) and control group (10 cases) according to the treatment plan. The therapeutic effects of the two groups were compared. Results: the negative rate of CSF cancer cells in the observation group was 63.6 and that in the control group was 40.0.The difference between the two groups was not statistically significant (P0.05). The remission rate of symptoms was 90.9 in the observation group and 40.0 in the control group. The difference between the two groups was statistically significant (P0.05). The median progression-free survival time was 7.8 months in the observation group and 5.3 months in the control group. The difference between the two groups was statistically significant (P0. 014). Conclusion: the patients with meningeal metastasis of lung adenocarcinoma with EGFR gene mutation taking malignant intracranial hypertension as the initial symptom were treated with gifitinib combined with ventriculoperitoneal shunt. It is expected to be a therapeutic regimen for patients with meningeal metastasis of lung adenocarcinoma with EGFR gene mutation.
【作者單位】： 鄭州大學人民醫(yī)院腫瘤內(nèi)科;鄭州大學人民醫(yī)院神經(jīng)外科;鄭州大學人民醫(yī)院放射科;鄭州大學人民醫(yī)院放療科;鄭州大學人民醫(yī)院胸外科;
【分類號】：R734.2

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