Department of Oncology, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei 10002, Taiwan.
Oncologist. 2011;16(1):82-6. doi: 10.1634/theoncologist.2010-0272. Epub 2011 Jan 6.
Brain metastasis was regarded, until recently, as a rare and late-stage event in patients with hepatocellular carcinoma (HCC). With the prolongation of survival in patients with advanced HCC by molecular targeted agents, this may have changed. We aimed to examine whether or not the incidence of brain metastasis in these patients has increased.
Between June 2005 and May 2009, 158 advanced HCC patients in total with either metastatic or locally advanced disease untreatable by locoregional therapies were enrolled in clinical trials of first-line antiangiogenic therapies. The clinicopathologic features and survival times of those who developed brain metastasis were analyzed.
Eleven (7%) of 158 advanced HCC patients, with a median follow-up of 26.6 months, were diagnosed with brain metastasis as a result of compatible symptoms, confirmed by brain imaging. All 11 patients had extrahepatic metastasis upon enrollment, and 10 of them had lung metastasis. The median time to brain metastasis was 9.6 months (range, 0.6-19.6 months). The median overall survival (OS) time after diagnosis of brain metastasis was 4.6 months (range, 0.7-12.6 months). Four patients received brain tumor excision, and their survival duration after brain metastasis tended to be longer than that of those who did not (median OS time, 6.1 months versus 3.1 months).
In the era of antiangiogenic targeted therapy, the importance of brain metastasis for advanced HCC patients may have increased.
脑转移在过去被认为是肝细胞癌（HCC）患者中一种罕见且晚期的事件。随着分子靶向药物延长晚期 HCC 患者的生存时间，这种情况可能已经发生了变化。我们旨在检查这些患者的脑转移发生率是否增加。
2005 年 6 月至 2009 年 5 月，共有 158 名患有转移性或局部晚期疾病且无法进行局部区域治疗的晚期 HCC 患者参加了一线抗血管生成治疗的临床试验。分析了发生脑转移的患者的临床病理特征和生存时间。
158 名晚期 HCC 患者中有 11 名（7%）患者被诊断为脑转移，中位随访时间为 26.6 个月，其诊断依据为与脑转移相符的症状，并经脑部影像学检查证实。所有 11 名患者在入组时均存在肝外转移，其中 10 名患者存在肺转移。脑转移的中位时间为 9.6 个月（范围 0.6-19.6 个月）。脑转移诊断后的中位总生存时间（OS）为 4.6 个月（范围 0.7-12.6 个月）。4 名患者接受了脑肿瘤切除术，他们的脑转移后生存时间倾向于长于未接受手术的患者（中位 OS 时间，6.1 个月与 3.1 个月）。
在抗血管生成靶向治疗时代，脑转移对晚期 HCC 患者的重要性可能已经增加。
