Chura J C, Shukla K, Argenta P A
Department of Obstetrics, Gynecology, and Women's Health, University of Minnesota, 420 Delaware Street, Minneapolis, MN 55455, USA.
Int J Gynecol Cancer. 2007 Jan-Feb;17(1):141-6. doi: 10.1111/j.1525-1438.2007.00808.x.
The aim of this study was to describe the features of patients with brain metastasis from cervical cancer. Twelve patients with brain metastasis from cervical cancer were identified. Information regarding symptoms, treatment, and survival was analyzed. The incidence of brain metastasis in our population was 0.77%. Median patient age at initial diagnosis of cervical cancer was 43.5 years (range 29-57 years) compared with 44.5 years (range 31-58 years) at identification of brain metastasis. Six patients had FIGO stage IB disease; three had stage IIB disease; and one each had stage IIIA, IIIB, and IVB disease. The median interval from diagnosis of cervical cancer to identification of brain metastasis was 17.5 months (range 1.1-96.1 months). All but one patient presented with neurologic symptoms. Eight patients received whole-brain irradiation and steroids, three received steroids alone, and one underwent surgery, followed by irradiation. All the patients who received whole-brain irradiation experienced improvement in their symptoms. Median survival from diagnosis of brain metastasis to death was 2.3 months (range 0.3-7.9 months). Five patients who received chemotherapy after brain irradiation had a median survival of 4.4 months compared to 0.9 months for those who received no additional treatment after brain irradiation (P= .016). Most patients with brain metastasis from cervical cancer presented with neurologic sequelae. Brain irradiation improved these symptoms. Survival after diagnosis of brain metastasis was poor; however, patients who received chemotherapy after brain irradiation appeared to have improved survival.
本研究的目的是描述宫颈癌脑转移患者的特征。确定了12例宫颈癌脑转移患者。分析了有关症状、治疗和生存的信息。我们研究人群中脑转移的发生率为0.77%。宫颈癌初诊时患者的中位年龄为43.5岁（范围29 - 57岁），而脑转移确诊时的中位年龄为44.5岁（范围31 - 58岁）。6例患者为国际妇产科联盟（FIGO）IB期疾病；3例为IIB期疾病；各有1例分别为IIIA、IIIB和IVB期疾病。从宫颈癌诊断到脑转移确诊的中位间隔时间为17.5个月（范围1.1 - 96.1个月）。除1例患者外，所有患者均出现神经症状。8例患者接受了全脑照射和类固醇治疗，3例仅接受类固醇治疗，1例接受了手术，随后进行照射。所有接受全脑照射的患者症状均有改善。从脑转移诊断到死亡的中位生存期为2.3个月（范围0.3 - 7.9个月）。脑照射后接受化疗的5例患者的中位生存期为4.4个月，而脑照射后未接受额外治疗的患者中位生存期为0.9个月（P = 0.016）。大多数宫颈癌脑转移患者出现神经后遗症。脑照射改善了这些症状。脑转移诊断后的生存率较差；然而，脑照射后接受化疗的患者似乎生存期有所改善。
