实体瘤柔脑膜转移疗效评价标准现状及进展  

Research progress and current status of response evaluation criteria in leptomeningeal metastasis of solid tumors

作　　者：李羽斌 李晓燕[1] Li Yubin;Li Xiaoyan(Department of Oncology,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)

机构地区：[1]首都医科大学附属北京天坛医院肿瘤内科,北京100070

出　　处：《中国肿瘤临床与康复》2024年第6期343-352,共10页Chinese Journal of Clinical Oncology and Rehabilitation

基　　金：北京市自然科学基金面上项目(7242007);北京市希思科临床肿瘤学研究基金会重点项目(Y-2021AST/zd-0127);北京天坛医院创新创业专项基金(2-2-2-015-01-04)。

摘　　要：柔脑膜转移(LM)是恶性肿瘤的一种致死性并发症,约有1%~5%的实体瘤患者会发生LM,以肺癌、乳腺癌、恶性黑色素瘤最为常见。LM诊断难、预后差,是临床诊疗的难点。疗效评价是恶性肿瘤治疗过程的重要环节之一,其核心要义在于监测肿瘤负荷的变化。目前,临床上主要通过影像学检查测量到的肿瘤直径变化来反映疗效,然而LM的影像学表现多为点状或线状强化,难以量化评估,单一影像学评价难以精准反映LM患者的病情变化。考虑到LM涉及到多个医学领域,如肿瘤学、神经影像学、神经病学、临床检验诊断学等,因此在多学科协助下建立一套简便、有效的LM评效标准,是现阶段临床的研究热点。文章就实体瘤LM疗效评价标准现状及进展予以综述。Leptomeningeal metastasis(LM)is a fatal complication of malignant tumors.LM occurs in about 1%-5%of patients with solid tumors,which are represented by those with lung cancer,breast cancer,and malignant melanoma.The difficulty in the clinical diagnosis and treatment is that the diagnosis of LM is difficult and the prognosis is poor.Response evaluation is one of the key links in the process of tumor treatment,and its core purpose is to monitor changes in tumor burden.At now,the curative effect is mainly manifested by changes in tumor diameter measured by imaging examinations.However,the imaging manifestations of LM are mostly dotted or linear enhancements,which are difficult to evaluate quantitatively.As such,a single imaging evaluation cannot showcase the condition of LM patients precisely.Given that LM multiple medical fields like oncology,neuroimaging,neurology,and clinical laboratory diagnostics are involved,it is the current clinic research hotspot to establish a set of simple and effective LM evaluation criteria with support of multiple disciplines.This paper will summarize the current status and progress of the evaluation standards for LM response in solid tumors.

关 键 词：实体瘤 肿瘤转移 脑膜 疗效评价 

分 类 号：R730.5[医药卫生—肿瘤]