Department of Neurosurgery, National Medical Center, 245 Eulgi-ro, Jung-gu, Seoul, 100-799, Republic of Korea.
Acta Neurochir (Wien). 2013 Mar;155(3):399-405. doi: 10.1007/s00701-012-1576-x. Epub 2012 Dec 14.
The optimal management of brain metastases from uterine cervix cancer (UCC) is not well defined because of the rarity of the condition and the scarcity of published reports. Here we report our experience with stereotactic radiosurgery for the management of brain metastases from UCC.
Thirteen consecutive patients with brain metastases from UCC were managed with a Leksell gamma-knife at our institution between January 2003 and December 2010. Clinical features and radiosurgical outcomes of patients were analyzed retrospectively.
Gamma-knife radiosurgery (GKRS) was chosen as the only treatment in four patients and performed in combination with whole-brain radiotherapy (WBRT) in nine patients. GKRS was conducted simultaneously with WBRT within a 1-month interval in six patients and was chosen as the salvage treatment after WBRT in three patients. The mean number of metastatic brain lesions per patient was 5.7 (range, 1-16). The median cumulative tumor volume was 23.7 cm(3) (range, 2.7-40.2 cm(3)), and the median marginal dose covering the tumors was 14 Gy of a 50 % isodose line (range, 8-25 Gy). Nine patients showed relief of main neurologic symptoms after GKRS. The median length of time that the patients spent in an improved neurologic state was 11.1 weeks (range, 2-39.6 weeks). The local and distant control rates were 66.7 % and 77.8 %, respectively. The median survival from the date of GKRS until death was 4.6 months (range, 1.0-15.9 months). The 6-month and 12-month survival rates after GKRS were 38 and 15 %, respectively.
GKRS could be an efficient palliative measure to relieve neurologic symptoms caused by brain metastasis from UCC.
由于宫颈癌脑转移（UCC）的罕见性和发表报告的稀缺性，其最佳治疗方法尚未明确。本研究旨在报告应用立体定向放射外科（GKRS）治疗 UCC 脑转移瘤的经验。
2003 年 1 月至 2010 年 12 月，我们机构对 13 例 UCC 脑转移患者采用 Leksell 伽玛刀进行治疗。回顾性分析患者的临床特征和放射外科治疗结果。
4 例患者仅接受 GKRS 治疗，9 例患者在 GKRS 的基础上联合全脑放疗（WBRT）。6 例患者在 1 个月内同时行 GKRS 和 WBRT，3 例患者在 WBRT 后行 GKRS 挽救治疗。患者的脑转移瘤数目为 116 个，平均 5.7 个；肿瘤累积体积为 2.740.2cm3，中位值为 23.7cm3；处方等剂量线为 50%时的边缘剂量为 825Gy，中位值为 14Gy。9 例患者 GKRS 后主要神经系统症状得到缓解。中位神经功能改善时间为 11.1 周（239.6 周）。局部控制率和远处控制率分别为 66.7%和 77.8%。GKRS 治疗后至死亡的中位生存时间为 4.6 个月（1.0~15.9 个月）。GKRS 治疗后 6 个月和 12 个月的生存率分别为 38%和 15%。
GKRS 可有效缓解 UCC 脑转移引起的神经症状，是一种有效的姑息治疗方法。
