[Meningeal carcinomatosis in patients with small cell lung cancer].
Six patients (2.7%) developed meningeal carcinomatosis among 207 patients with small cell lung cancer (SCLC) receiving intensive combination chemotherapy. The cumulative probability of developing meningeal carcinomatosis was 2.7% at 3 years and 7.8% at 5 years after diagnosis of SCLC. Pain in legs, gait disturbance, headache, nausea and vomiting were the characteristic symptoms at the onset of meningeal carcinomatosis. Although cytological examination of cerebro-spinal fluid (CSF) was essential for the diagnosis of meningeal carcinomatosis, elevated protein, LDH, CEA and/or NSE concentration and decreased glucose concentration in CSF were also helpful for the diagnosis. For treatment of meningeal carcinomatosis, all patients received intrathecal administration of methotrexate, cytosine arabinoside and/or prednisolone. Additionally, 3 patients received spinal irradiation, and one received cerebro-spinal irradiation. However, only 2 patients responded, and survival was brief ranging from 2 to 38 weeks. Development of meningeal carcinomatosis seems to be a rare event; however, it may be an obstacle to the prolongation of patient survival in the treatment of SCLC.
Ohnoshi
T
T
Department of Medicine, Okayama University of Medical School.
Ueoka
H
H
Kiura
K
K
Mima
Y
Y
Miyatake
K
K
Genba
K
K
Matsumura
T
T
Chikamori
M
M
Hiraki
S
S
Kimura
I
I
D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002277:Carcinoma / Q000453:epidemiology*; D018288:Carcinoma, Small Cell / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000453:epidemiology; D008297:Male; D008577:Meningeal Neoplasms / Q000453:epidemiology*; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000453:epidemiology*; D012189:Retrospective Studies