title: 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.affiliation: Division of Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Nagano
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Kotani
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Kobayashi
authors.forename: Yukihisa
authors.initials: Y
authors.lastname: Hatakeyama
authors.forename: Suya
authors.initials: S
authors.lastname: Hori
authors.forename: Daisuke
authors.initials: D
authors.lastname: Kasai
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Funada
authors.forename: Hideki
authors.initials: H
authors.lastname: Nishimura
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kondoh
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Nishimura
mesh_terms: D002289:Carcinoma, Non-Small-Cell Lung / Q000235:genetics / Q000628:therapy*; D003131:Combined Modality Therapy; D066246:ErbB Receptors / Q000235:genetics; D000069347:Erlotinib Hydrochloride; D000077156:Gefitinib; D006801:Humans; D008175:Lung Neoplasms / Q000235:genetics / Q000628:therapy*; D008297:Male; D055756:Meningeal Carcinomatosis / Q000235:genetics / Q000556:secondary* / Q000628:therapy*; D008875:Middle Aged; D009154:Mutation; D011799:Quinazolines / Q000627:therapeutic use; D018714:Radiotherapy, Adjuvant; D013997:Time Factors; D016896:Treatment Outcome; D017287:Ventriculoperitoneal Shunt
chemical_list: D011799:Quinazolines; D000069347:Erlotinib Hydrochloride; D066246:ErbB Receptors; D000077156:Gefitinib