卵巢上皮性癌脑转移10例临床分析

Epithelial ovarian carcinoma metastatic to the brain: report on ten cases with review of literature

目的 探讨卵巢上皮性癌脑转移的发生率、诊断、治疗及预后等相关因素。方法 回顾性分析 1 996～ 2 0 0 1年 ,收治的卵巢上皮性癌 478例中发生脑转移 1 0例患者的临床资料。结果 卵巢上皮性癌脑转移的发生率为 2 1 % ;脑转移常见的首发症状为头痛、呕吐、肢体乏力 ;常见的转移部位为脑顶部及枕部。 1 0例患者中 ,8例行颅脑放射治疗及全身化学药物治疗 ,其中 7例完成了治疗 ,颅脑照射剂量 ,单发病灶为 30～ 38Gy/ 4周 ,多发病灶为 40～ 45Gy/ 5周。 1 0例患者总体中位生存时间为 6 3个月 ,其中 7例完成治疗者为 8 3个月 ,3例放弃治疗及未完成治疗者为 1 4个月。结论 脑转移的诊断主要依据临床症状、体征及影像学检查 ;联合应用颅脑放射治疗及全身化学药物治疗 。

Objective To investigate the incidence,the diagnosis,the multimodal treatment and the relevant factors of the brain metastases in patients with epithelial ovarian carcinoma(EOC) Method The clinical data were analysed in 10 cases of brain metastases from 478 cases of EOC after treatment between 1996-2001 Results The incidence of brain metastases in EOC was 2 1% The most common manifestation of the brain metastases was headache,nausea and limb paralysis The most common metastatic sites were the cupular and occipital part of the cerebra.Seven of ten patients were treated with brain radiation and systemic chemotherapy, three abandoned The brain irradiation dosage was 30-38 Gy for only one focus in the brain lasting for 4 weeks and 40-45 Gy for two or three foci in the brain lasting for 5 weeks The overall survival after identification of brain metastases was <1-33 months,the overall median survival was 6 3 months,but for those who abandoned treatment, the median survival was 1 4 months vs 8 3 months for those who completed the courses of therapy Conclusions The diagnosis of brain metastasis was based on the clinical features and the imagings and the therapy was comprehensive and palliative However,the number and size of the brain metastases and its reaction to radiation was significantly associated with the prognosis Although the survival after the identificaton of brain metastases in EOC is poor, most patients can be palliated successfully by using a combination of radiation therapy and systemic chemotherapy