Mizokami Yoshihito, Mitsuya Koichi, Hayashi Nakamasa, Yasui Hirofumi, Harada Hideyuki, Nishimura Tetsuo, Nakasu Yoko
Division of Neurosurgery, Shizuoka Cancer Center.
No Shinkei Geka. 2013 Aug;41(8):669-77.
Metastatic brain tumors have become a critical issue in clinical management for patients with cancer. We retrospectively analysed features of 105 patients with metastatic brain tumors from gastrointestinal cancer, who underwent treatment in our institute between September, 2002 and December, 2010. Treatment strategy was individualized according to the patient's systemic and neurologic conditions, size and location of the brain metastases, and expectant systemic treatment through our cancer board. Treatment outcome was significantly better in patients with RTOG RPA class 2 than in those with class 3(8.6 months vs 3.5 months: p<0.05). Metastatic brain tumors were diagnosed at 6.3/13.1/15.7 months after diagnosis of metastatic lung tumors from esophagus/stomach/colon cancers respectively. A third of the patients with metastatic brain tumor from rectal cancer presented without evident lung metastasis. In conclusion, patients with brain metastasis from gastrointestinal cancers can achieve improvement in survival with early diagnosis and multidisciplinary individualized treatments.
转移性脑肿瘤已成为癌症患者临床治疗中的一个关键问题。我们回顾性分析了2002年9月至2010年12月期间在我院接受治疗的105例胃肠道癌转移性脑肿瘤患者的特征。治疗策略根据患者的全身和神经状况、脑转移瘤的大小和位置以及通过我们的癌症委员会进行的预期全身治疗进行个体化制定。放射肿瘤学研究组(RTOG)RPA 2级患者的治疗结果明显优于3级患者(8.6个月对3.5个月:p<0.05)。食管/胃/结肠癌转移性肺肿瘤诊断后,分别在6.3/13.1/15.7个月诊断出转移性脑肿瘤。三分之一的直肠癌转移性脑肿瘤患者在没有明显肺转移的情况下出现。总之,胃肠道癌脑转移患者通过早期诊断和多学科个体化治疗可实现生存改善。