title: Miliary brain metastases in 2 cases with advanced non-small cell lung cancer harboring EGFR mutation during gefitinib treatment.
abstract: Here we report 2 cases of non-small cell lung cancer (NSCLC) with sensitive epidermal growth factor receptor (EGFR) gene mutation that developed miliary brain metastases characterized by dementia and disorientation during gefitinib therapy. One patient's therapy was switched from gefitinib to chemotherapy followed by whole brain radiotherapy (WBRT), which resulted in disease progression with coma. Gefitinib reinitiation improved the patient's symptoms. The other patient continued gefitinib during WBRT and achieved complete remission of the miliary metastases and lived 18 months longer. These results suggest that gefitinib concomitant with WBRT is an optional strategy for the treatment of patients with EGFR-mutated NSCLC with miliary metastases to prevent disease flare.
authors.affiliation: Division of Pulmonary Medicine, St. Luke's International Hospital, 9-1Akashi-cho, Tokyo 104-8560, Japan. sayakam0920@gmail.com
authors.forename: Sayaka
authors.initials: S
authors.lastname: Mochizuki
authors.forename: Naoki
authors.initials: N
authors.lastname: Nishimura
authors.forename: Akira
authors.initials: A
authors.lastname: Inoue
authors.forename: Koji
authors.initials: K
authors.lastname: Murakami
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Nukiwa
authors.forename: Naohiko
authors.initials: N
authors.lastname: Chohnabayashi
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000473:pathology* / Q000556:secondary*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy / Q000235:genetics* / Q000473:pathology* / Q000532:radiotherapy; D005260:Female; D000077156:Gefitinib; D018773:Genes, erbB-1 / Q000235:genetics*; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000235:genetics* / Q000473:pathology* / Q000532:radiotherapy; D008875:Middle Aged; D009154:Mutation; D011799:Quinazolines / Q000627:therapeutic use*
chemical_list: D000970:Antineoplastic Agents; D011799:Quinazolines; D000077156:Gefitinib