单莹, 杨佳欣, 沈铿, 郎景和, 吴鸣, 黄惠芳, 潘凌亚. 卵巢上皮性癌脑转移7例临床分析及文献复习[J]. 中国肿瘤临床, 2008, 35(7): 375-377.
引用本文: 单莹, 杨佳欣, 沈铿, 郎景和, 吴鸣, 黄惠芳, 潘凌亚. 卵巢上皮性癌脑转移7例临床分析及文献复习[J]. 中国肿瘤临床, 2008, 35(7): 375-377.
SHAN Ying, YANG Jia-xin, SHEN Qiang, LANG Jing-he, WU Ming, HUANG Hui-fang, PAN Ling-ya. Brain Metastasis from Epithelial Ovarian Cancer: Analysis of 7 Cases and Literature Review[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2008, 35(7): 375-377.
Citation: SHAN Ying, YANG Jia-xin, SHEN Qiang, LANG Jing-he, WU Ming, HUANG Hui-fang, PAN Ling-ya. Brain Metastasis from Epithelial Ovarian Cancer: Analysis of 7 Cases and Literature Review[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2008, 35(7): 375-377.

卵巢上皮性癌脑转移7例临床分析及文献复习

Brain Metastasis from Epithelial Ovarian Cancer: Analysis of 7 Cases and Literature Review

  • 摘要: 目的: 总结卵巢上皮性癌脑转移的临床特点,治疗方法及影响预后的因素。 方法: 回顾分析1986年1月~2007年3月北京协和医院收治的7例卵巢上皮性癌脑转移患者的临床资料,同时复习近5年相关文献中的160例脑转移患者临床资料,总结其治疗方法及影响预后的因素。 结果: 卵巢上皮性癌脑转移的发生率约为0.8%(124/15192)。病理类型以浆液性腺癌最为多见,78例(49.0%)。其中早期患者(Ⅰ~Ⅱ期)占17.0%,晚期患者占83.0%。病理学诊断应作为卵巢癌患者脑转移的金标准。自患者确诊卵巢癌到出现脑转移平均间隔时间14.4~42.0个月。脑转移灶为单发的患者占43.0%,57.0%为颅内多发转移;55.0%的患者存在颅外转移。颅压增高导致的头痛呕吐为常见的临床表现。血清CA125作为卵巢癌复发以及脑转移发生后病情监测的指标有一定应用价值。患者的生存期平均约12个月。治疗前应对患者进行全面正确的评估,选择合理的个体化治疗方案。治疗方法以手术联合放疗或放疗联合化疗等联合治疗效果较好,可以明显延长生存期。 结论: 卵巢上皮性癌脑转移比较少见,但随着卵巢癌患者治疗效果的提高及生存期的延长,其发病率逐渐上升,患者一旦出现脑转移,预后较差,联合治疗可以适当延长生存期。

     

    Abstract: Objective: To investigate the clinical characteristics, treatment, and prognosis of brain metastasis from epithelial ovarian cancer. Methods: We retrospectively reviewed the clinical data from 7 patients with brain metastasis of epithelial ovarian cancer seen in our hospital from January 1986 to March 2007. We also reviewed literature on this topicpublished within the past 5 years. Results: All 7 patients seen in our hospital were at stage Ⅲ~ Ⅳ when they were initial-ly diagnosed. Three cases were identified as serous adenocarcinoma, the most common type. Three cases had solitarymetastatic lesions in the brain, and the other 4 cases had multiple metastatic lesions. Four cases had extracranial metastat-ic lesions. The interval between the initial diagnosis and the detection of metastases in the brain was 20.0~32.7 months. Atotal of 160 cases of brain metastasis from epithelial ovarian cancer has been reported in the past 5 years. Seventy-eight(49.0%) of the 160 patients were identified with serous adenocarcinoma. At the initial diagnosis, 17.0% of them were stageⅠ or Ⅱ cancers, and 83.0% were stage Ⅲ or Ⅳ cancers. There were solitary metastatic lesions in the brain in 53.4%.The interval between the initial diagnosis and detection of metastases in the brain was 14.4~42.0 months. Extracranialmetastases were detected in 55.0% of the patients. Headache and vomiting were the most common clinical manifestations.Serum CA125 level was valuable in evaluating and monitoring the state of the disease. The mean survival was 7.9~16.1months in the 7 patients we reviewed and 15.9~4 months in the 160 patients from the literature. Conclusion: Brain metas-tases from epithelial ovarian cancer are uncommon and suggest a poor prognosis. Such patients should be evaluated com-prehensively before undergoing individual treatment. Combined use of radiotherapy and chemotherapy is effective.

     

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