[Two cases of meningeal carcinomatosis during gefitinib therapy for non-small cell lung cancer].

"Case 1" A 56-year-old woman who suffered from postoperative recurrent non-small cell lung cancer received gefitinib therapy. Approximately 7 months after the therapy was begun, although the intrathoracic disease responded to the treatment, she developed meningeal carcinomatosis and died of rapidly progressive central nervous system disease. "Case 2" A 46-year-old man with stage IV non-small cell lung cancer started gefitinib therapy after chemotherapy. The pulmonary lesions markedly improved responding to gefitinib therapy, however, approximately 6 months after the therapy was begun, multiple brain metastasis and meningeal carcinomatosis were detected. Approximately 4 months after the diagnosis of meningeal carcinomatosis, he died of disease progression and disturbance of consciousness. It has been reported that the central nervous system is a frequent metastatic site of non-small cell lung cancer in patients treated with gefitinib. We report two cases of meningeal carcinomatosis that occurred during the period in which their intrathoracic disease was responding to gefitinib therapy. We should consider the possibility of metastatic central nervous system disease, even in patients in whom gefitinib therapy is apparently successful.