摘要
Background. Brain represents a rare site of metastasis in patients with epithe lial ovarian carcinoma (EOC).Case report. We observed a case of multiple brain m etastases in an EOC patient after complete response of a pelvic recurrence to pl atinum/paclitaxel chemotherapy. Complete response of brain metastases was observ ed after whole brain radiotherapy and subsequent chemotherapy by combination of cisplatin and gemcitabine. Three subsequent recurrences of brain metastases were controlled by re-treatment by the combination of 5-fluorouracil, cisplatin an d gemcitabine. Methods. Because of limited information on the outcome of EOC bra in metastases in reported case series, a pooled analysis of the published report s in patients with EOC brain metastases was performed. Data were extracted from 46 reports that contained sufficient details on 189 individual patients. The sur vival was analyzed by the Kaplan-Meier method. Univariate and multivariate anal yses were performed by the log-rank test and Cox method, respectively. Results. The most favorable outcome was observed in patients treated by surgery combined with radiotherapy and/or chemotherapy. The survival was significantly better in reports describing only one or two cases, in patients diagnosed after 1992, in patients who received therapy in addition to symptomatic treatment, in patients treated by radiotherapy, chemotherapy and surgery, in patients without extracran ial metastases and with single brain metastases. On multivariate analysis, the a bsence of extracranial metastases, treatment by chemotherapy, surgery and radiot herapy were independent positive predictors of survival. Conclusions. EOC brain metastases are responsive to chemotherapy. An aggressive multidisciplinary thera peutic approach including chemotherapy may lead to prolonged survival.
Background. Brain represents a rare site of metastasis in patients with epithe lial ovarian carcinoma (EOC).Case report. We observed a case of multiple brain m etastases in an EOC patient after complete response of a pelvic recurrence to pl atinum/paclitaxel chemotherapy. Complete response of brain metastases was observ ed after whole brain radiotherapy and subsequent chemotherapy by combination of cisplatin and gemcitabine. Three subsequent recurrences of brain metastases were controlled by re-treatment by the combination of 5-fluorouracil, cisplatin an d gemcitabine. Methods. Because of limited information on the outcome of EOC bra in metastases in reported case series, a pooled analysis of the published report s in patients with EOC brain metastases was performed. Data were extracted from 46 reports that contained sufficient details on 189 individual patients. The sur vival was analyzed by the Kaplan-Meier method. Univariate and multivariate anal yses were performed by the log-rank test and Cox method, respectively. Results. The most favorable outcome was observed in patients treated by surgery combined with radiotherapy and/or chemotherapy. The survival was significantly better in reports describing only one or two cases, in patients diagnosed after 1992, in patients who received therapy in addition to symptomatic treatment, in patients treated by radiotherapy, chemotherapy and surgery, in patients without extracran ial metastases and with single brain metastases. On multivariate analysis, the a bsence of extracranial metastases, treatment by chemotherapy, surgery and radiot herapy were independent positive predictors of survival. Conclusions. EOC brain metastases are responsive to chemotherapy. An aggressive multidisciplinary thera peutic approach including chemotherapy may lead to prolonged survival.
