PDF(Pubmed)
Abstract：
BACKGROUND: Prostate cancer is the second most common cancer in men. Central nervous system (CNS) involvement in prostate cancer which manifests as cerebral, leptomeningeal, or dural involvement is uncommon and occurs late in the course of disease.
METHODS: A 60-year-old patient with castration resistant prostate cancer (CRPC) presented with headache and fatigue. Evaluation revealed bone marrow and leptomeningeal involvement. The patient treated by whole brain radiotherapy, leuprolide, weekly docetaxel and daily 1000 mg abiraterone. Complete blood count (CBC) and CNS symptoms improved and the patient is alive after 11 months with excellent performance status.
CONCLUSIONS: Leptomeningeal involvement in prostate cancer is rare and is associated with a poor prognosis but the possibility of such event should be considered in patients with new onset progressive CNS symptoms. New treatment strategies such as combination of docetaxel and abiraterone added to androgen deprivation therapy (triplet therapy) might improve outcome in these patients.
METHODS: A 60-year-old patient with castration resistant prostate cancer (CRPC) presented with headache and fatigue. Evaluation revealed bone marrow and leptomeningeal involvement. The patient treated by whole brain radiotherapy, leuprolide, weekly docetaxel and daily 1000 mg abiraterone. Complete blood count (CBC) and CNS symptoms improved and the patient is alive after 11 months with excellent performance status.
CONCLUSIONS: Leptomeningeal involvement in prostate cancer is rare and is associated with a poor prognosis but the possibility of such event should be considered in patients with new onset progressive CNS symptoms. New treatment strategies such as combination of docetaxel and abiraterone added to androgen deprivation therapy (triplet therapy) might improve outcome in these patients.
摘要：
背景：前列腺癌是男性中第二常见的癌症。中枢神经系统（CNS）参与前列腺癌，表现为大脑，软脑膜,或硬脑膜受累并不常见，并且在病程后期发生。
方法：一名患有去势抵抗性前列腺癌（CRPC）的60岁患者出现头痛和疲劳。评估显示骨髓和软脑膜受累。患者接受了全脑放射治疗，亮丙瑞林,每周多西他赛和每日1000毫克阿比特龙。全血细胞计数（CBC）和中枢神经系统症状得到改善，患者在11个月后仍存活，表现良好。
结论：前列腺癌的脑膜受累是罕见的，并且与不良预后相关，但新出现的进行性中枢神经系统症状的患者应考虑此类事件的可能性。新的治疗策略如多西他赛和阿比特龙联合应用于雄激素剥夺治疗（三联疗法）可能会改善这些患者的预后。
方法：一名患有去势抵抗性前列腺癌（CRPC）的60岁患者出现头痛和疲劳。评估显示骨髓和软脑膜受累。患者接受了全脑放射治疗，亮丙瑞林,每周多西他赛和每日1000毫克阿比特龙。全血细胞计数（CBC）和中枢神经系统症状得到改善，患者在11个月后仍存活，表现良好。
结论：前列腺癌的脑膜受累是罕见的，并且与不良预后相关，但新出现的进行性中枢神经系统症状的患者应考虑此类事件的可能性。新的治疗策略如多西他赛和阿比特龙联合应用于雄激素剥夺治疗（三联疗法）可能会改善这些患者的预后。
