子宫颈癌脑转移

Cervical carcinoma metastasis to the brain

目的:研究子宫颈癌脑转移(CCMB)的发生机理与临床表现,探讨其治疗方法与预后。方法:回顾分析11例CCMB患者的临床病理资料及随访记录。结果:Ⅰb期2例,Ⅱa期2例,Ⅲb期7例;鳞状细胞癌6例,腺鳞癌2例,小细胞癌2例,腺癌1例;癌细胞分化程度均为低分化。8例伴有肺、肝等器官转移,3例无其它器官转移;原发宫颈癌控制2例,未控4例,进展5例。从诊断宫颈癌至诊断脑转移平均间隔14.6个月;头痛是CCMB最常见的症状。脑转移病灶≥2个8例,仅3例有1个病灶。手术+全脑放射治疗(WBRT)3例,立体定位性放射外科手术(SRS)3例,WBRT5例。11例平均生存时间为6.6个月(1～13个月)。结论:CCMB不一定是宫颈癌晚期的并发症,也可发生于早期患者,与组织学类型、癌细胞低分化、晚期等因素密切相关,手术和SRS是目前较为理想的治疗方法。

Objective: To study the mechanism, clinical symptom, and its therapy regimens and prognosis of cervical carcinoma metastasis to the brain ( CCMB) . Methods: 11 patients with CCMB were retrospectively analyzed. Results: Two cases were stage I b,two were II a, and seven were IIIb. Six were squamous cell carcinoma, 2 were adenosquamous carcinoma, 2 were small cell carcinoma, and 1 was adenocarcinoma. All cases were poorly differentiated carcinoma. 8 were accompanied by lungs and livers metastases disease and 3 had not any other systemic metastases at the time of the brain metastases diagnosis.2 were controlled of primary disease,and other 9 were uncontrolled local-regional disease. The median interval from the diagnosis of the primary carcinoma to the detection of brain was 14.6 months. The headache was the most common symptom. Multiple brain lesions developed in 8 of 11 patients and only 3 cases had a single lesion of brain metastases. 3 with surgery followed by whole brain radiation therapy (WBRT), 3 were treated with stereotactic radiosurgery (SRS),and 5 with WBRT alone. All patients had a median survival of 6.6 months. Conclusions: The CCMB is not always late complication of cervical carcinoma, it also maybe occurs in earlier stage patients. It relates to histology, low grade, and late stage. Surgery and SRS are the appropriate therapy for patients with CCMB.