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[食管癌脑转移:临床特征与治疗结果]

[Brain metastases from esophageal cancers: clinical features and treatment results].

作者信息

Sueyama H, Yamanoi T, Uematu T, Saitou M, Sakai K, Sugita T, Tsuchida E, Matumoto Y, Sasamoto R, Ito T

机构信息

Division of Radiation Therapy, Niigata Prefectural Central Hospital.

出版信息

Nihon Igaku Hoshasen Gakkai Zasshi. 2001 Sep;61(10):534-9.

Abstract

Metastatic brain tumors from esophageal cancer are relatively rare. We analyzed the clinical features and results of treatment in 14 cases of brain metastases from esophageal carcinoma. The average time to diagnosis of brain metastases in the 11 patients with metachronous lesions was 13 months. The average age of patients at the diagnosis of brain metastasis was 65 years. Most patients had T4 or N1 disease at the time of diagnosis of esophageal cancer. Performance status of grade 3 was most frequent at the time of diagnosis of brain metastasis. Treatment for brain metastases was surgery followed by radiation in five cases, radiotherapy alone in seven cases, and conservative treatment in two cases. The median survival time of all patients from the treatment of brain metastases was 2 months, with only one patient alive after more than one year. Improvement in neurological symptoms was demonstrated in 42% of cases. These extremely poor treatment results reflect the fact that most patients at the time of diagnosis of brain metastasis had poor performance status and the presence of extracerebral metastases. Therefore, a short-course, high-dose-per-fraction treatment for brain metastases from esophageal cancer should be selected from the viewpoint of quality of life.

摘要

食管癌脑转移瘤相对少见。我们分析了14例食管癌脑转移患者的临床特征及治疗结果。11例异时性病变患者诊断为脑转移的平均时间为13个月。患者诊断为脑转移时的平均年龄为65岁。大多数患者在诊断食管癌时已处于T4或N1期。脑转移诊断时最常见的体能状态为3级。脑转移的治疗方法为5例行手术加放疗,7例行单纯放疗,2例行保守治疗。所有患者自脑转移治疗后的中位生存时间为2个月,仅有1例患者存活超过1年。42%的病例神经症状有改善。这些极差的治疗结果反映出大多数患者在诊断脑转移时体能状态较差且存在脑外转移。因此,从生活质量的角度出发,应选择短疗程、高分割剂量治疗食管癌脑转移。

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