Li Zi-ting, Fu Shi-long
Department of Gynecological Oncology, Cancer Hospital Affiliated to Fudan University, Shanghai 200032, China.
Zhonghua Fu Chan Ke Za Zhi. 2003 May;38(5):287-9.
To investigate the incidence, the diagnosis, the multimodal treatment and the relevant factors of the brain metastases in patients with epithelial ovarian carcinoma (EOC).
The clinical data were analysed in 10 cases of brain metastases from 478 cases of EOC after treatment between 1996 - 2001.
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.
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 identification of brain metastases in EOC is poor, most patients can be palliated successfully by using a combination of radiation therapy and systemic chemotherapy.
探讨上皮性卵巢癌（EOC）患者脑转移的发生率、诊断、多模式治疗及相关因素。
分析1996年至2001年期间478例接受治疗的EOC患者中10例脑转移患者的临床资料。
EOC患者脑转移的发生率为2.1%。脑转移最常见的表现为头痛、恶心和肢体瘫痪。最常见的转移部位是大脑的顶部和枕部。10例患者中有7例接受了脑部放疗和全身化疗，3例放弃治疗。脑部仅一个转移灶的放疗剂量为30 - 38 Gy，持续4周；脑部有两个或三个转移灶的放疗剂量为40 - 45 Gy，持续5周。确诊脑转移后的总生存期为<1 - 33个月，总中位生存期为6.3个月，但放弃治疗者的中位生存期为1.4个月，而完成治疗疗程者为8.3个月。
脑转移的诊断基于临床特征和影像学检查，治疗是综合性的且为姑息性的。然而，脑转移灶的数量、大小及其对放疗的反应与预后显著相关。尽管EOC患者确诊脑转移后的生存率较低，但大多数患者通过放疗和全身化疗联合应用可成功缓解症状。
