Khuntia Deepak, Sajja Ratna, Chidel Mark A, Lee Shih-Yuan, Rice Thomas W, Adelstein David J, Carlson Thomas P, Saxton Jerrold P, Barnett Gene H, Suh John H
Brain Tumor Institute, Department of Radiation Oncology, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
Technol Cancer Res Treat. 2003 Jun;2(3):267-72. doi: 10.1177/153303460300200309.
There are over 200,000 cases of brain metastases (BrM) every year, but very few are from esophageal cancer primaries. In order to determine predictors for outcome of these patients, the authors conducted a retrospective review of twenty-seven patients with BrM from esophageal carcinoma diagnosed at the Cleveland Clinic Foundation between 1991 and 2001. For the entire cohort, median follow-up and median survival was 3.6 months and 3.6 months, respectively. On univariate analysis, patients with Karnofsky Performance Status (KPS) >/= 70, low recursive partitioning analysis score, single BrM, no systemic disease, and aggressive treatment [surgery, stereotactic radiosurgery (SRS) + whole brain radiation (WBRT), SRS + surgery + WBRT, surgery + WBRT)] had a significantly improved survival. In a multivariate model, patients with higher KPS and aggressive treatment had improved survival. The 1-year survival for the WBRT alone group and the aggressive treatment group was 6%, and 36% respectively. We conclude that based on the data presented here, patients with BrM from esophageal cancer have poor outcome. Aggressive treatment and favorable KPS are associated with longer survival for selected patients. We recommend esophageal cancer patients with BrM be enrolled in clinical trials to better delineate the role of treatment and potentially improve results.
每年有超过20万例脑转移（BrM）病例，但很少是由食管癌原发灶引起的。为了确定这些患者的预后预测因素，作者对1991年至2001年在克利夫兰诊所基金会诊断为食管癌脑转移的27例患者进行了回顾性研究。对于整个队列，中位随访时间和中位生存期分别为3.6个月和3.6个月。单因素分析显示，卡诺夫斯基功能状态（KPS）≥70、低递归分区分析评分、单发脑转移、无全身疾病以及积极治疗[手术、立体定向放射外科（SRS）+全脑放疗（WBRT）、SRS+手术+WBRT、手术+WBRT]的患者生存期显著改善。在多变量模型中，KPS较高且接受积极治疗的患者生存期改善。单纯WBRT组和积极治疗组的1年生存率分别为6%和36%。我们得出结论，根据此处提供的数据，食管癌脑转移患者预后较差。积极治疗和良好的KPS与部分患者更长的生存期相关。我们建议食管癌脑转移患者参加临床试验，以更好地明确治疗的作用并可能改善治疗结果。
