Hwang Jong Ha, Yoo Heon Jong, Lim Myong Cheol, Seo Sang-Soo, Kang Sokbom, Kim Joo-Young, Park Sang-Yoon
Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea.
J Obstet Gynaecol Res. 2013 Jan;39(1):287-91. doi: 10.1111/j.1447-0756.2012.01927.x. Epub 2012 Jun 13.
The purpose of this study was to describe the features of patients with brain metastasis from cervical cancer.
The medical records of patients with cervical cancer between February 2001 and June 2011 were reviewed retrospectively. Clinical characteristics, symptoms, treatment and survival in patients with brain metastasis were analyzed.
Eleven patients with brain metastasis from cervical cancer were identified, representing an incidence of brain metastasis in the study population of 0.45%. Median patient age at initial diagnosis of cervical cancer was 50 years (range 33-75 years). Non-squamous cell carcinoma was diagnosed in six (54.5%) of the 11 patients, with small cell carcinoma diagnosed in two patients. Ten of the 11 patients had lung-related metastasis at presentation; eight patients had lung metastasis, one had mediastinal lymph node metastasis, and one had pleural metastasis. The median interval from diagnosis of cervical cancer to identification of brain metastasis was 15.4 months (range 3.4-83.3 months). Nine patients presented with neurologic symptoms, such as headache, nausea, vomiting, seizure and extremity weakness. Initially, six patients received whole brain radiotherapy: three patients received chemotherapy; one underwent surgery; and one patient refused treatment. The median survival time after diagnosis of the brain metastases was 5.9 months (range 0.7-19 months).
The prognosis after diagnosis of the brain metastasis in patients with uterine cervical cancer is poor. The small cell type and lung metastasis seem to be related with brain metastasis and may be regarded as risk factors.
本研究旨在描述宫颈癌脑转移患者的特征。
回顾性分析2001年2月至2011年6月期间宫颈癌患者的病历。分析脑转移患者的临床特征、症状、治疗及生存情况。
共确定11例宫颈癌脑转移患者，在研究人群中脑转移发生率为0.45%。宫颈癌初诊时患者的中位年龄为50岁（范围33 - 75岁）。11例患者中有6例（54.5%）诊断为非鳞状细胞癌，其中2例为小细胞癌。11例患者中有10例在就诊时伴有肺转移；8例有肺转移，1例有纵隔淋巴结转移，1例有胸膜转移。从宫颈癌诊断到发现脑转移的中位间隔时间为15.4个月（范围3.4 - 83.3个月）。9例患者出现神经系统症状，如头痛、恶心、呕吐、癫痫发作和肢体无力。最初，6例患者接受了全脑放疗；3例患者接受了化疗；1例接受了手术；1例患者拒绝治疗。脑转移诊断后的中位生存时间为5.9个月（范围0.7 - 19个月）。
宫颈癌患者脑转移诊断后的预后较差。小细胞类型和肺转移似乎与脑转移有关，可被视为危险因素。
