Long-term outcome after multidisciplinary approach for leptomeningeal carcinomatosis in a non-small cell lung cancer patient with poor performance status.

Abstract

The present study describes a case of a 60-year-old Japanese man who was histologically diagnosed with lung adenocarcinoma harboring L858R mutation of epidermal growth factor receptor. He was successfully treated with gefitinib, but eventually developed leptomeningeal carcinomatosis. He underwent ventriculoperitoneal shunting for hydrocephalus and received erlotinib in place of gefitinib with concurrent whole brain radiotherapy; this resulted in dramatic improvement in his symptoms and performance status from four to one and he survived for as long as 13.6 months after the initiation of erlotinib therapy. This multidisciplinary approach may be particularly useful in terms of increasing survival and improving quality of life.

• Authors: Tatsuya Nagano, Yoshikazu Kotani, Kazuyuki Kobayashi, Yukihisa Hatakeyama, Suya Hori, Daisuke Kasai, Yasuhiro Funada, Hideki Nishimura, Takeshi Kondoh, Yoshihiro Nishimura
• Journal: Internal medicine (Tokyo, Japan) (Intern Med) Vol. 50 Issue 24 Pg. 3019-22 ( 2011) ISSN: 1349-7235 [Electronic] Japan
• PMID: 22185996 (Publication Type: Case Reports, Journal Article, Review)

Chemical References

• Quinazolines
• Erlotinib Hydrochloride
• ErbB Receptors
• Gefitinib

Topics

• Carcinoma, Non-Small-Cell Lung (genetics, therapy)
• Combined Modality Therapy
• ErbB Receptors (genetics)
• Erlotinib Hydrochloride
• Gefitinib
• Humans
• Lung Neoplasms (genetics, therapy)
• Male
• Meningeal Carcinomatosis (genetics, secondary, therapy)
• Middle Aged
• Mutation
• Quinazolines (therapeutic use)
• Radiotherapy, Adjuvant
• Time Factors
• Treatment Outcome
• Ventriculoperitoneal Shunt