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[胃癌脑转移患者的临床结局]

[Clinical outcomes in patients with brain metastasis from gastric cancer].

作者信息

Tamura Shigeyuki, Takeno Atsushi, Miki Hirofumi, Uchiyama Chieko, Kanemura Takashi, Ono Hisako, Hamanaka Michiko, Suzuki Rei, Nakahira Shin, Nakata Ken, Takeda Yutaka

机构信息

Dept. of Gastroenterological Surgery, Kansai Rosai Hospital.

出版信息

Gan To Kagaku Ryoho. 2011 Nov;38(12):2093-6.

Abstract

Brain metastasis from gastric cancer is uncommon and difficult to treat. Patients with brain metastasis had a poor prognosis with simultaneous and multiple metastases to other organs. Four patients with brain metastasis were reported. All patients were male with the median age of 76 years and the diagnosis was stage IA in one, stage IIIA in 2 and stage IV in one. Three patients underwent gastrectmy and one patient in stage IV received chemotherapy as the initial treatment. An interval between the initial treatment and the diagnosis of brain metastasis was 11, 24, 30 and 83 months, respectively. The symptoms of brain metastasis were stagger in two, unconsciousness in one and headache in one. The treatment for brain metastases were a surgical resection for two lesions larger than 3 cm and gamma-knife radiotherapy was performed for the other lesions. The duration of survival from the treatment for brain metastasis was 45, 48, 58 and 94 days, respectively. Multidisciplinary treatment, including a surgical resection and stereotactic radiosurgery such as gamma-knife for brain metastasis is thought to improve the quality of life, but not prolong survival due to metastases to other organs. The development of effective systemic treatment will be necessary in order to prolong survival.

摘要

胃癌脑转移并不常见且难以治疗。脑转移患者预后较差,常同时伴有其他器官的多发转移。本文报告了4例脑转移患者。所有患者均为男性,中位年龄76岁,其中1例诊断为IA期,2例为IIIA期,1例为IV期。3例患者接受了胃切除术,1例IV期患者初始治疗接受了化疗。初始治疗至脑转移诊断的间隔时间分别为11、24、30和83个月。脑转移症状中,2例出现共济失调,1例意识丧失,1例头痛。对于大于3 cm的2个病灶进行了手术切除,其他病灶则接受了伽马刀放射治疗。脑转移治疗后的生存时间分别为45、48、58和94天。包括手术切除和伽马刀等立体定向放射外科治疗在内的多学科治疗被认为可改善生活质量,但由于存在其他器官转移,无法延长生存期。为了延长生存期,有必要开发有效的全身治疗方法。

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