Mahmoud-Ahmed A S, Suh J H, Barnett G H, Webster K D, Belinson J L, Kennedy A W
Department of Radiation Oncology, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
Gynecol Oncol. 2001 Nov;83(2):305-9. doi: 10.1006/gyno.2001.6384.
The objective of this study was to investigate the effectiveness of radiation therapy as a treatment for brain metastases from endometrial carcinoma.
Between July 1985 and November 1999, 10 patients with brain metastases from endometrial carcinoma were treated at the Cleveland Clinic. We reviewed the patient and tumor characteristics at the time of the primary diagnosis and the brain metastases diagnosis. For the 8 patients who received radiation therapy with or without surgery, we analyzed the treatment results with regard to survival and local control of the metastases.
Brain metastases from endometrial carcinoma were commonly accompanied by uncontrolled local-regional disease and systemic metastases. Multiple brain lesions developed in 7 of 10 patients. Two patients were treated with surgery alone and had a median survival of 2.75 months (4 and 1.5 months) after the brain metastases diagnosis. Three patients were treated with surgery and radiation therapy and lived for a median survival of 15 months (range 11.5 to 15.5 months). The 5 patients who were treated with radiation therapy without surgery had a median survival of 2.4 months (range 0.25 to 6 months). Patients with multiple brain metastases had a shorter survival than patients with a single metastasis.
Overall survival after brain metastases development in patients with endometrial carcinoma was poor. Although the number of patients was small, radiation therapy alone resulted in poor survival. Combination treatment with surgery and radiation therapy may improve survival for selected patients.
本研究的目的是调查放射治疗作为子宫内膜癌脑转移瘤治疗方法的有效性。
1985年7月至1999年11月期间，克利夫兰诊所对10例子宫内膜癌脑转移患者进行了治疗。我们回顾了初次诊断和脑转移诊断时的患者及肿瘤特征。对于8例接受了放疗（无论是否联合手术）的患者，我们分析了转移灶的生存情况和局部控制方面的治疗结果。
子宫内膜癌脑转移通常伴有局部区域疾病未得到控制和全身转移。10例患者中有7例出现多发脑转移灶。2例仅接受手术治疗，脑转移诊断后的中位生存期为2.75个月（4个月和1.5个月）。3例接受了手术和放射治疗，中位生存期为15个月（范围11.5至15.5个月）。5例未接受手术仅接受放射治疗的患者中位生存期为2.4个月（范围0.25至6个月）。多发脑转移患者的生存期比单发转移患者短。
子宫内膜癌患者发生脑转移后的总体生存期较差。尽管患者数量较少，但单纯放射治疗导致生存期较差。手术和放射治疗联合治疗可能会改善部分患者的生存期。
