绒毛膜癌脑转移4例分析

The analysis of choriocarcinoma with brain metastases in 4 cases

目的 探讨绒毛膜癌（以下简称绒癌）脑转移的临床特点、治疗方法、预后影响因素。方法 回顾性分析2011年1月至2014年1月西安交通大学第一附属医院收治的绒癌脑转移4例患者的临床资料。4例患者均接受多药联合的全身及局部化疗8~29个周期,其中2例行开颅手术清除病灶,1例行γ刀颅内放射治疗及肺部病灶切除术,1例未行任何手术治疗。结果 4例均达到部分缓解,其中2例分别在随诊2月、1年后复发。结论 绒癌脑转移预后较差。早期诊断是改善预后的关键,诊断脑转移前是否接受过化疗是影响其预后的重要因素,目前脑转移的治疗仍然存在争议,全身多药联合化疗兼顾局部化疗及手术、放疗,仍然是现阶段治疗的主要手段。

Objective To explore the clinical metastases. Methods Clinical date of 4 patients of ch features, treatment and prognostic factors of choriocarcinoma with brain with brain metastases during Jan 2011 to Jan 2014 in The First Affiliated Hospital of Xi＇ an Jiao Tong University were retrospectively reviewed. All the patients were received the systemic or local multi - drug chemotherapy for 8 - 29 courses, 2 patients underwent craniotomy to remove lesions, 1 patient received Gamma knife radiotherapy and lung surgical intervention, The other patient did not take any surgery. Results All patients received partial remission, 2 patients had recurrence respectively after 2 months and 1 year follow - up. Conclusion Tshe cboriocarcinoma with brain metastases has the poor of prognosis. Early diagnosis is the key to improve prognosis, whether treated with chemotherapy is one of the important factors to affect the prognosis before the diagnosis of brain metastases. At present, the treatment of choriocarcinomas with brain metastases is still controversial, The current therapeutic approach of this condition includes both multi - drug combination chemotherapy, local chemotherapy, surgery, and radiotherapy.