Department of Radiation Oncology, Andreas Cancer Center-Mayo Health System, Mankato, MN 56002, USA.
World J Gastroenterol. 2011 May 21;17(19):2407-10. doi: 10.3748/wjg.v17.i19.2407.
To determine the incidence of brain metastasis in a contemporary group of patients with carcinoma of the esophagus.
Retrospective analysis of 53 patients with esophageal carcinoma who received radiotherapy as a component of treatment between 1998 and 2007, including patient and tumor characteristics, and subsequent diagnosis of brain metastasis. The association between the histological type of esophageal cancer and the incidence of brain metastasis was assessed using Fisher's exact test.
Forty-four of the fifty-three patients in this study had adenocarcinoma and nine had squamous cell carcinoma, ranging from stage IIA-IVB. Primary treatment was surgery with neoadjuvant chemoradiotherapy (trimodality therapy) in 19% of patients; chemoradiotherapy in 42%; and surgery and adjuvant radiotherapy in 7%. Twenty-five percent of patients in this study received palliative radiotherapy. The overall incidence of brain metastasis in this cohort was 13%. Adenocarcinoma was the primary tumor histology in all of the patients who developed brain metastasis, representing an incidence of 16% in this subgroup. No patients with squamous cell carcinoma received trimodality therapy. The association between histology and brain metastasis was not statistically significant.
The incidence of brain metastasis in this contemporary cohort of patients with esophageal carcinoma is higher than previously reported and was confined to those with adenocarcinoma.
确定在一组当代食管癌患者中脑转移的发生率。
回顾性分析了 1998 年至 2007 年间接受放疗作为治疗一部分的 53 例食管癌患者的资料，包括患者和肿瘤特征，以及随后诊断为脑转移的情况。使用 Fisher 确切检验评估食管癌的组织学类型与脑转移发生率之间的关联。
本研究中 53 例患者中有 44 例为腺癌，9 例为鳞癌，从 IIA 期到 IVB 期不等。主要治疗方法为手术联合新辅助放化疗（三联疗法），占 19%；放化疗占 42%；手术加辅助放疗占 7%。本研究中有 25%的患者接受姑息性放疗。该队列的总体脑转移发生率为 13%。发生脑转移的患者均为腺癌，占该亚组的 16%。没有鳞癌患者接受三联疗法。组织学与脑转移之间的关联无统计学意义。
在这组当代食管癌患者中，脑转移的发生率高于以往报道，且仅限于腺癌患者。
