摘要
目的探讨鞘内注射甲氨蝶呤治疗脑膜癌的疗效、安全性和预后。方法回顾性分析接受甲氨蝶呤鞘内注射化疗的22例脑膜癌患者的临床资料,分析鞘内注射化疗的疗效、不良反应及预后。结果 22例患者均接受鞘内注射化疗,14例(63.9%)头痛减轻,3例(13.6%)精神行为异常缓解;6例患者出现鞘内注射相关不良反应,其中神经根受刺激症状5例,Ⅲ度骨髓抑制1例;复查脑脊液(CSF)细胞学检查显示,8例患者CSF肿瘤细胞转阴性。鞘内注射前后脑脊液蛋白质、葡萄糖、氯化物改变情况比较,差异无统计学意义(P>0.05)。Cox回归分析显示,Karnofsky功能状态(KPS)评分、酪氨酸激酶抑制剂(TKI)治疗为患者预后的影响因素。结论鞘内注射甲氨喋呤未见严重不良反应,可部分改善脑膜癌患者临床症状,鞘内注射化疗是脑膜癌的一种可靠治疗手段。
Objective To investigate the efficacy, security and prognosis of intrathecal injection of methotrexate(MTX) in treatment of meninges carcinoma. Methods Clinical data of 22 meninges carcinoma patients treated by intrathecal injection of MTX were retrospectively reviewed, and the clinical efficacy, adverse events as well as prognosis after intrathecal chemotherapy were analyzed. Results All 22 patients were treated by intrathecal injection of MTX, 14 patients(63.9%)with headache and 3 patients(13.6%)with mental and behavior disorder improved after treatment. Six patients had adverse events in the course of intrathecal injection, among whom five patients had nerve root irritation and one patient suffered grade III myelosuppression. Cerebrospinal fluid(CSF) cytology reexamination showed that CSF tumor cells were negative in 8 patients. However, there were no significant differences in the changes of cerebrospinal fluid protein, glucose and chloride before and after intrathecal injection(P>0.05). Cox regression analysis showed that Karnofsky Performance Scale(KPS) score and tyrosine kinase inhibitor(TKI) therapy were prognostic influencing factors. Conclusion Intrathecal administration of MTX can partially improve the clinical symptoms of meninges carcinoma patients with no severe adverse events observed. Intrathecal injection for chemotherapy is a reliable treatment of meninges carcinoma.
作者
马伟锋
张弥兰
张涛
张梦歌
贾琳琳
刘慧勤
蒋玙姝
秦灵芝
袁丽品
李玮
MA Weifeng;ZHANG Milan;ZHANG Tao;ZHANG Mengge;JIA Linlin;LIU Huiqin;JIANG Yushu;QIN Lingzhi;YUAN Lipin;LI Wei(Department of Neurology,Zhengzhou University People's Hospital,Henan Provincial People′s Hospital,Zhengzhou,Henan,450003;Xinxiang Medical University,Xinxiang,Henan,453000)
出处
《实用临床医药杂志》
CAS
2022年第2期23-27,共5页
Journal of Clinical Medicine in Practice
基金
河南省医学科技攻关计划项目(SBGJ2018077)。
关键词
脑膜癌
鞘内注射化疗
甲氨蝶呤
预后
影响因素
meninges carcinoma
chemotherapy by intrathecal injection
methotrexate
prognosis
influencing factor
