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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">clinicaloncology</journal-id><journal-title-group><journal-title xml:lang="ru">Клинический случай в онкологии</journal-title><trans-title-group xml:lang="en"><trans-title>Clinical Case in Oncology</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">3034-1477</issn><issn pub-type="epub">3034-4018</issn><publisher><publisher-name>ОНКОПРАКТИК</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.62546/3034-1477-2025-3-3-67-74</article-id><article-id custom-type="elpub" pub-id-type="custom">clinicaloncology-137</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>КЛИНИЧЕСКИЕ СЛУЧАИ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>CASE REPORTS</subject></subj-group></article-categories><title-group><article-title>Клинический случай применения интратекального введения этопозида у пациента с лептоменингеальным метастазированием немелкоклеточного рака легкого</article-title><trans-title-group xml:lang="en"><trans-title>А clinical case of etoposide intrathecal administration in a patient with leptomeningial metastasis of nonsmall cell lung cancer</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-9413-367X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Фатеева</surname><given-names>А. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Fateeva</surname><given-names>Anastasia A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Фатеева Анастасия Валерьевна</p><p>690002, Приморский край, г. Владивосток, пр-т Острякова, д. 2 </p><p>141407, Московская область, городской округ Химки, Куркинское шоссе, д. 11 </p></bio><bio xml:lang="en"><p>2, Ostryakova Ave., Primorsky Krai, Vladivostok, 690002</p><p>11, Kurkinskoe highway, Moscow region, Khimki, 141407</p></bio><email xlink:type="simple">ralise@bk.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГБОУ ВО «Тихоокеанский государственный медицинский университет»; ГБУЗ Московской области «Химкинская клиническая больница»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Pacific State Medical University; Khimki Clinical Hospital</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2025</year></pub-date><pub-date pub-type="epub"><day>28</day><month>01</month><year>2026</year></pub-date><volume>3</volume><issue>3</issue><fpage>67</fpage><lpage>74</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Фатеева А.В., 2026</copyright-statement><copyright-year>2026</copyright-year><copyright-holder xml:lang="ru">Фатеева А.В.</copyright-holder><copyright-holder xml:lang="en">Fateeva A.A.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.oncocase.ru/jour/article/view/137">https://www.oncocase.ru/jour/article/view/137</self-uri><abstract><p>Лептоменингеальное метастазирование немелкоклеточного рака легкого представляет собой редкую и сложную клиническую ситуацию. Отсутствие рандомизированных клинических исследований осложняет процесс выбора подходящих методов лечения с доказанной эффективностью для данной когорты пациентов и зачастую ставит клиницистов в затруднительное положение. В связи с этим поиск возможных потенциально эффективных вариантов лечения для пациентов с лептоменингеальными метастазами, является важным направлением. Здесь представлено описание клинического случая лечения пациента с плоскоклеточным раком легкого с применением интратекальной химиотерапии этопозидом.</p></abstract><trans-abstract xml:lang="en"><p>Leptomeningial metastasis of non-small cell lung cancer is a rare and complex clinical case. The lack of randomized clinical trials complicates the process of choosing appropriate treatment methods with the proven efficacy for this cohort of patients and often puts clinicians in a difficult position. Therefore, the search for possible potentially effective treatment options for patients with leptomeningeal metastases is an important direction. Here is a description of a clinical case of a patient with squamous cell lung cancer treatment using intrathecal chemotherapy with etoposide.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>плоскоклеточный рак легкого</kwd><kwd>лептоменингеальное метастазирование</kwd><kwd>этопозид</kwd><kwd>интратекальная химиотерапия</kwd><kwd>поражение ЦНС</kwd></kwd-group><kwd-group xml:lang="en"><kwd>squamous cell lung cancer</kwd><kwd>leptomeningial metastasis</kwd><kwd>etoposide</kwd><kwd>intrathecal chemotherapy</kwd><kwd>CNS lesion</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Cagney D.N., Martin A.M., Catalano P.J., Redig A.J., Lin N.U., Lee E.Q. et al. Incidence and prognosis of patients with brain metastases at diagnosis of systemic malignancy: a population-based study // NeuroOncol. 2017. Vol. 19. Р. 1511–1521. https://doi.org/10.1093/neuonc/nox077.</mixed-citation><mixed-citation xml:lang="en">Cagney D.N., Martin A.M., Catalano P.J., Redig A.J., Lin N.U., Lee E.Q. et al. Incidence and prognosis of patients with brain metastases at diagnosis of systemic malignancy: a population-based study // NeuroOncol. 2017. Vol. 19. Р. 1511–1521. https://doi.org/10.1093/neuonc/nox077.</mixed-citation></citation-alternatives></ref><ref id="cit2"><label>2</label><citation-alternatives><mixed-citation xml:lang="ru">Kang Y., Jin Y., Li Q., Yuan X. Advances in lung cancer driver genes associated with brain metastasis // Front Oncol. 2020. Vol. 10606300. https://doi.org/10.3389/fonc.2020.606300.</mixed-citation><mixed-citation xml:lang="en">Kang Y., Jin Y., Li Q., Yuan X. Advances in lung cancer driver genes associated with brain metastasis // Front Oncol. 2020. Vol. 10606300. https://doi.org/10.3389/fonc.2020.606300.</mixed-citation></citation-alternatives></ref><ref id="cit3"><label>3</label><citation-alternatives><mixed-citation xml:lang="ru">Wang B., Guo H., Xu H., Yu H., Chen Y., Zhao G. Research progress and challenges in the treatment of central nervous system metastasis of non-small cell lung cancer // Cells. 2021. Vol. 10. Р. 2620 https://doi.org/10.3390/cells10102620.</mixed-citation><mixed-citation xml:lang="en">Wang B., Guo H., Xu H., Yu H., Chen Y., Zhao G. Research progress and challenges in the treatment of central nervous system metastasis of non-small cell lung cancer // Cells. 2021. Vol. 10. Р. 2620 https://doi.org/10.3390/cells10102620.</mixed-citation></citation-alternatives></ref><ref id="cit4"><label>4</label><citation-alternatives><mixed-citation xml:lang="ru">Pellerino A., Internò V., Muscolino E., Mo F., Bruno F., Pronello E. et al. Leptomeningeal metastases from non-small cell lung cancer: State of the art and recent advances // J.Cancer Metastasis Treat. 2020. Vol. 6, No. 41. https://doi.org/10.20517/2394-4722.2020.80.</mixed-citation><mixed-citation xml:lang="en">Pellerino A., Internò V., Muscolino E., Mo F., Bruno F., Pronello E. et al. Leptomeningeal metastases from non-small cell lung cancer: State of the art and recent advances // J.Cancer Metastasis Treat. 2020. Vol. 6, No. 41. https://doi.org/10.20517/2394-4722.2020.80.</mixed-citation></citation-alternatives></ref><ref id="cit5"><label>5</label><citation-alternatives><mixed-citation xml:lang="ru">Le Rhun E., Weller M., van den Bent M., Brandsma D., Furtner J., Ruda R. et al. Leptomeningeal metastasis from solid tumours: EANO-ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up // ESMO Open. 2023. Vol. 8101624. https://doi.org/10.1016/j.esmoop.2023.101624.</mixed-citation><mixed-citation xml:lang="en">Le Rhun E., Weller M., van den Bent M., Brandsma D., Furtner J., Ruda R. et al. Leptomeningeal metastasis from solid tumours: EANO-ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up // ESMO Open. 2023. Vol. 8101624. https://doi.org/10.1016/j.esmoop.2023.101624.</mixed-citation></citation-alternatives></ref><ref id="cit6"><label>6</label><citation-alternatives><mixed-citation xml:lang="ru">Le Rhun E., Preusser M., van den Bent M., Andratschke N., Weller M. How we treat patients with leptomeningeal metastases // ESMO Open. 2019. Vol. 4. e000507.</mixed-citation><mixed-citation xml:lang="en">Le Rhun E., Preusser M., van den Bent M., Andratschke N., Weller M. How we treat patients with leptomeningeal metastases // ESMO Open. 2019. Vol. 4. e000507.</mixed-citation></citation-alternatives></ref><ref id="cit7"><label>7</label><citation-alternatives><mixed-citation xml:lang="ru">Gwak H.S. Joo J. Kim S. Yoo H. Shin S.H. Han J.Y. et al. Analysis of treatment outcomes of intraventricular chemotherapy in 105 patients for leptomeningeal carcinomatosis from non-small-cell lung cancer // J. Thorac. Oncol. 2013. Vol. 8. Р. 599–605. https://doi.org/10.1097/JTO.0b013e318287c943.</mixed-citation><mixed-citation xml:lang="en">Gwak H.S. Joo J. Kim S. Yoo H. Shin S.H. Han J.Y. et al. Analysis of treatment outcomes of intraventricular chemotherapy in 105 patients for leptomeningeal carcinomatosis from non-small-cell lung cancer // J. Thorac. Oncol. 2013. Vol. 8. Р. 599–605. https://doi.org/10.1097/JTO.0b013e318287c943.</mixed-citation></citation-alternatives></ref><ref id="cit8"><label>8</label><citation-alternatives><mixed-citation xml:lang="ru">Riess J.W., Nagpal S., Iv M., Zeineh M., Gubens M.A. Ramchandran K. et al. Prolonged survival of patients with nonsmall-cell lung cancer with leptomeningeal carcinomatosis in the modern treatment era // Clin. Lung Cancer. 2014. Vol. 15. Р. 202–206. https://doi.org/10.1016/j.cllc.2013.12.009.</mixed-citation><mixed-citation xml:lang="en">Riess J.W., Nagpal S., Iv M., Zeineh M., Gubens M.A. Ramchandran K. et al. Prolonged survival of patients with nonsmall-cell lung cancer with leptomeningeal carcinomatosis in the modern treatment era // Clin. Lung Cancer. 2014. Vol. 15. Р. 202–206. https://doi.org/10.1016/j.cllc.2013.12.009.</mixed-citation></citation-alternatives></ref><ref id="cit9"><label>9</label><citation-alternatives><mixed-citation xml:lang="ru">Yang J.C., Kim S.W., Kim D.W., Lee J.S., Cho B.C., Ahn J.S. et al. Osimertinib in patients with epidermal growth factor receptor mutation-positive non-small-cell lung cancer and leptomeningeal metastases: The BLOOM Study // J.Clin.Oncol. 2020. Vol. 38. Р. 538–547. https://doi.org/10.1200/JCO.19.00457.</mixed-citation><mixed-citation xml:lang="en">Yang J.C., Kim S.W., Kim D.W., Lee J.S., Cho B.C., Ahn J.S. et al. Osimertinib in patients with epidermal growth factor receptor mutation-positive non-small-cell lung cancer and leptomeningeal metastases: The BLOOM Study // J.Clin.Oncol. 2020. Vol. 38. Р. 538–547. https://doi.org/10.1200/JCO.19.00457.</mixed-citation></citation-alternatives></ref><ref id="cit10"><label>10</label><citation-alternatives><mixed-citation xml:lang="ru">Lee S.J., Lee J.I., Nam D.H., Ahn Y.C., Han J.H., Sun J.M. et al. Leptomeningeal carcinomatosis in non-small-cell lung cancer patients: impact on survival and correlated prognostic factors // J. Thorac. Oncol. 2013. Vol. 8. Р. 185–191. https://doi.org/10.1097/JTO.0b013e3182773f21.</mixed-citation><mixed-citation xml:lang="en">Lee S.J., Lee J.I., Nam D.H., Ahn Y.C., Han J.H., Sun J.M. et al. Leptomeningeal carcinomatosis in non-small-cell lung cancer patients: impact on survival and correlated prognostic factors // J. Thorac. Oncol. 2013. Vol. 8. Р. 185–191. https://doi.org/10.1097/JTO.0b013e3182773f21.</mixed-citation></citation-alternatives></ref><ref id="cit11"><label>11</label><citation-alternatives><mixed-citation xml:lang="ru">Le Rhun E., Devos P., Weller J., Seystahl K., Mo F., Compter A. et al. Prognostic validation and clinical implications of the EANO ESMO classification of leptomeningeal metastasis from solid tumors // NeuroOncol. 2021. Vol. 23. Р. 1100–1112. https://doi.org/10.1093/neuonc/noaa29.</mixed-citation><mixed-citation xml:lang="en">Le Rhun E., Devos P., Weller J., Seystahl K., Mo F., Compter A. et al. Prognostic validation and clinical implications of the EANO ESMO classification of leptomeningeal metastasis from solid tumors // NeuroOncol. 2021. Vol. 23. Р. 1100–1112. https://doi.org/10.1093/neuonc/noaa29.</mixed-citation></citation-alternatives></ref><ref id="cit12"><label>12</label><citation-alternatives><mixed-citation xml:lang="ru">Alexander M., Lin E., Cheng H. Leptomeningeal metastases in non-small cell lung cancer: optimal systemic management in NSCLC with and without driver mutations // Curr. Treat. Options Oncol. 2020. Vol. 21. Р. 72. https://doi.org/10.1007/s11864-020-00759-3.</mixed-citation><mixed-citation xml:lang="en">Alexander M., Lin E., Cheng H. Leptomeningeal metastases in non-small cell lung cancer: optimal systemic management in NSCLC with and without driver mutations // Curr. Treat. Options Oncol. 2020. Vol. 21. Р. 72. https://doi.org/10.1007/s11864-020-00759-3.</mixed-citation></citation-alternatives></ref><ref id="cit13"><label>13</label><citation-alternatives><mixed-citation xml:lang="ru">Boogerd W., van den Bent M.J., Koehler P.J. et al. The relevance of intraventricular chemotherapy for leptomeningeal metastasis in breast cancer: a randomised study // Eur. J. Cancer. 2004. Vol. 40. Р. 2726–2733.</mixed-citation><mixed-citation xml:lang="en">Boogerd W., van den Bent M.J., Koehler P.J. et al. The relevance of intraventricular chemotherapy for leptomeningeal metastasis in breast cancer: a randomised study // Eur. J. Cancer. 2004. Vol. 40. Р. 2726–2733.</mixed-citation></citation-alternatives></ref><ref id="cit14"><label>14</label><citation-alternatives><mixed-citation xml:lang="ru">Le Rhun E., Wallet J., Mailliez A. et al. Intrathecal liposomal cytarabine plus systemic therapy versus systemic chemotherapy alone for newly diagnosed leptomeningeal metastasis from breast cancer // NeuroOncol. 2020. Vol. 22. Р. 524–538.</mixed-citation><mixed-citation xml:lang="en">Le Rhun E., Wallet J., Mailliez A. et al. Intrathecal liposomal cytarabine plus systemic therapy versus systemic chemotherapy alone for newly diagnosed leptomeningeal metastasis from breast cancer // NeuroOncol. 2020. Vol. 22. Р. 524–538.</mixed-citation></citation-alternatives></ref><ref id="cit15"><label>15</label><citation-alternatives><mixed-citation xml:lang="ru">Grossman S.A. Finkelstein D.M. Ruckdeschel J.C. et al. Randomized prospective comparison of intraventricular methotrexate and thiotepa in patients with previously untreated neoplastic meningitis. Eastern Cooperative Oncology Group // J. Clin. Oncol. 1993. Vol. 11. Р. 561–569.</mixed-citation><mixed-citation xml:lang="en">Grossman S.A. Finkelstein D.M. Ruckdeschel J.C. et al. Randomized prospective comparison of intraventricular methotrexate and thiotepa in patients with previously untreated neoplastic meningitis. Eastern Cooperative Oncology Group // J. Clin. Oncol. 1993. Vol. 11. Р. 561–569.</mixed-citation></citation-alternatives></ref><ref id="cit16"><label>16</label><citation-alternatives><mixed-citation xml:lang="ru">Fan C., Zhao Q., Li L. et al. Efficacy and safety of intrathecal pemetrexed combined with dexamethasone for treating tyrosine kinase inhibitor-failed leptomeningeal metastases from EGFR-mutant NSCLC-a prospective, open-label, single-arm phase 1/2 clinical trial (unique identifier: ChiCTR1800016615) // J. Thorac. Oncol. 2021. Vol. 16. Р. 1359–1368.</mixed-citation><mixed-citation xml:lang="en">Fan C., Zhao Q., Li L. et al. Efficacy and safety of intrathecal pemetrexed combined with dexamethasone for treating tyrosine kinase inhibitor-failed leptomeningeal metastases from EGFR-mutant NSCLC-a prospective, open-label, single-arm phase 1/2 clinical trial (unique identifier: ChiCTR1800016615) // J. Thorac. Oncol. 2021. Vol. 16. Р. 1359–1368.</mixed-citation></citation-alternatives></ref><ref id="cit17"><label>17</label><citation-alternatives><mixed-citation xml:lang="ru">Glitza Oliva I.C., Ferguson S.D., Bassett R. et al. Concurrent intrathecal and intravenous nivolumab in leptomeningeal disease: phase 1 trial interim results // Nat. Med. 2023. Vol. 29. Р. 898–905.</mixed-citation><mixed-citation xml:lang="en">Glitza Oliva I.C., Ferguson S.D., Bassett R. et al. Concurrent intrathecal and intravenous nivolumab in leptomeningeal disease: phase 1 trial interim results // Nat. Med. 2023. Vol. 29. Р. 898–905.</mixed-citation></citation-alternatives></ref><ref id="cit18"><label>18</label><citation-alternatives><mixed-citation xml:lang="ru">Fleischhack G., Reif S., Hasan C. et al. Feasibility of intraventricular administration of etoposide in patients with metastatic brain tumours // Br.J.Cancer. 2001. Vol. 84, No. 11. Р. 1453–1459.</mixed-citation><mixed-citation xml:lang="en">Fleischhack G., Reif S., Hasan C. et al. Feasibility of intraventricular administration of etoposide in patients with metastatic brain tumours // Br.J.Cancer. 2001. Vol. 84, No. 11. Р. 1453–1459.</mixed-citation></citation-alternatives></ref><ref id="cit19"><label>19</label><citation-alternatives><mixed-citation xml:lang="ru">Min Jae Park Prolonged Response of Meningeal Carcinomatosis from Non-small Cell Lung Cancer to Salvage Intrathecal Etoposide Subsequent to Failure of First-Line Methotrexate: A Case Report and Literature Review // Am.J.Case Rep. 2015. Vol. 16. Р. 224–227. Published online 2015 Apr 16. doi: 10.12659/AJCR.894061.</mixed-citation><mixed-citation xml:lang="en">Min Jae Park Prolonged Response of Meningeal Carcinomatosis from Non-small Cell Lung Cancer to Salvage Intrathecal Etoposide Subsequent to Failure of First-Line Methotrexate: A Case Report and Literature Review // Am.J.Case Rep. 2015. Vol. 16. Р. 224–227. Published online 2015 Apr 16. doi: 10.12659/AJCR.894061.</mixed-citation></citation-alternatives></ref><ref id="cit20"><label>20</label><citation-alternatives><mixed-citation xml:lang="ru">Bonomi Ph. et al. Comparison of Survival and Quality of Life in Advanced Non-Small-Cell Lung Cancer Patients Treated With Two Dose Levels of Paclitaxel Combined With Cisplatin Versus Etoposide With Cisplatin: Results of an Eastern Cooperative Oncology Group Trial // J. Clin. Oncol. 2000. Vol. 18, Nо. 3. https://doi.org/10.1200/JCO.2000.18.3.623.</mixed-citation><mixed-citation xml:lang="en">Bonomi Ph. et al. Comparison of Survival and Quality of Life in Advanced Non-Small-Cell Lung Cancer Patients Treated With Two Dose Levels of Paclitaxel Combined With Cisplatin Versus Etoposide With Cisplatin: Results of an Eastern Cooperative Oncology Group Trial // J. Clin. Oncol. 2000. Vol. 18, Nо. 3. https://doi.org/10.1200/JCO.2000.18.3.623.</mixed-citation></citation-alternatives></ref></ref-list><fn-group><fn fn-type="conflict"><p>The authors declare that there are no conflicts of interest present.</p></fn></fn-group></back></article>
