Abstract:
Objective To evaluate the clinical efficacy and side effects of icotinib combined with a subarachnoid space implantable pump for the treatment of leptomeningeal metastases (LM) from lung adenocarcinoma.
Methods Seven cases of LM from lung adenocarcinoma with epidermal growth factor receptor mutation were included in the study from March 2011 to September 2015. With the aid of anesthetists, all patients were implanted with subarachnoid space implantable pumps to drain the cerebrospinal fluid (CSF) and then treated with icotinib (125 mg, three times a day) until disease progression or unacceptable toxicities. After 4 weeks, the efficacy and tolerability of icotinib were evaluated on the basis of symptoms, tumor markers from CSF, and brain gadolinium-enhanced magnetic resonance imaging scans.
Results Among the seven patients evaluated, no patient had complete response, two patients had partial response, four had stable disease, and one had progression. The patient who was progressive died at a month after therapy. The survival time of all the other patients was more than 4 months. The common adverse effects of icotinib were skin rash and diarrhea, mainly in grades 1 and 2. No infection of the local subarachnoid drainage tube was found in the abdominal wall.
Conclusion Icotinib combined with a subarachnoid space implantable pump for the treatment of LM from lung adenocarcinoma may be effective, and the toxicities are tolerable. This method could also obviously alleviate the clinical symptoms and improve the quality of life of the patients, worthy of further study.
下载: