Tajima Yusuke, Ishibashi Keiichiro, Ishiguro Toru, Osawa Tomonori, Sakimoto Takehiko, Okada Norimichi, Miyazaki Tatsuya, Yokoyama Masaru, Yamano Takafumi, Nishimura Keiichiro, Hondo Mikito, Takahashi Takeo, Ishida Hideyuki
Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University.
Gan To Kagaku Ryoho. 2009 Nov;36(12):2245-7.
This retrospective study was performed to evaluate the outcomes of 12 patients with brain metastasis from colorectal cancer treated between 1999 and 2008. The range of patients was 33-72 years old (median: 64 years old). The male to female ratio was 2:1. The primary site was the colon in 4 patients and rectum in 8 patients. The site of brain metastasis was the cerebrum in 8 and cerebellum in 4. All brain lesions were metachronously detected. Three patients had a single lesion each, while the remaining 9 had multiple lesions. The range of the period from the resection of the primary lesion to the detection of brain metastasis was 144-2,062 days (median: 868 days). The types of treatment included whole brain radiotherapy after cerebral metastatectomy in three patients with a single lesion, whole brain radiotherapy only in 7 patients with multiple lesions, and modified FOLFOX6 (mFOLFOX6) regimen combined with whole brain radiation in recently treated two patients with multiple brain and lung metastases. The median overall survival period was 107 days. The longest survivor was a patient who survived for 505 days after the start of mFOLFOX6 plus radiation therapy. It appears that how we control metastases has become more important in recent years. For example, using new drugs, extracranial metastases of controllable cancer have become better controllable over longer periods.
本回顾性研究旨在评估1999年至2008年间接受治疗的12例结直肠癌脑转移患者的治疗结果。患者年龄范围为33 - 72岁（中位数：64岁）。男女比例为2:1。原发部位为结肠的有4例，直肠的有8例。脑转移部位在大脑的有8例，小脑的有4例。所有脑转移灶均为异时性发现。3例患者各有1个病灶，其余9例有多个病灶。从原发灶切除到发现脑转移的时间范围为144 - 2062天（中位数：868天）。治疗方式包括：3例单发病灶患者在脑转移瘤切除术后接受全脑放疗；7例多发病灶患者仅接受全脑放疗；最近治疗的2例脑和肺多发转移患者接受改良FOLFOX6（mFOLFOX6）方案联合全脑放疗。总生存期的中位数为107天。最长存活者是1例在开始mFOLFOX6加放疗后存活了505天的患者。近年来，如何控制转移似乎变得更加重要。例如，使用新药后，可控制癌症的颅外转移在更长时间内变得更好控制。
