妊娠滋养细胞肿瘤脑转移的治疗

Management of brain metastases in gestational trophoblastic neoplasia

妊娠滋养细胞肿瘤(GTN)是一类少见的来源于胎盘滋养细胞的恶性肿瘤,疾病早期即可发生远处转移,其中发生脑转移患者约占10%。GTN脑转移一旦发生病情往往比较危重,是疾病恶化和患者死亡的主要原因之一。EMA/CO方案为主的多药联合化疗基础上结合鞘内MTX注射、手术治疗、全脑放疗等综合治疗,可使约70%的患者获得完全缓解,获得总体较好的预后。

Gestational trophoblastic neoplasia(GTN)is an uncommon spectrum of malignant diseases that arise from proliferation of trophoblastic cells.GTN is prone to metastasize to distant organs even in an early stage.Patients present with brain metastases represent about 10%in all GTN patients.This site of metastatic disease has long been recognized as a high-risk site of metastasis,and the main cause of neurological deterioration and death.Relative good prognosis has been achieved based on the treatment of multi-agent chemotherapy EMA/CO regimen combined with intrathecal methotrexate,or craniotomy,or whole-brain irradiation,and 70%patients with GTN brain metastases receive complete remission.