Niu Xiaoyu, Rajanbabu Anupama, Delisle Megan, Peng Feng, Vijaykumar Dehannathuparambil K, Pavithran Keechilattu, Feng Yukuan, Lau Susie, Gotlieb Walter H, Press Joshua Z
Obstetric and Gynecologic Department, Sichuan University Huaxi Second Hospital, Sichuan Province, China.
Surgical and Gynecologic Oncology, Amrita Vishwavidyapeetham, Kochi, Kerala, India.
J Obstet Gynaecol Can. 2013 Sep;35(9):816-822. doi: 10.1016/S1701-2163(15)30838-0.
To explore the impact of treatment modality on survival in patients with brain metastases from epithelial ovarian cancer.
We conducted a retrospective review of cases of ovarian cancer with brain metastases treated at institutions in three countries (Canada, China, and India) and conducted a search for studies regarding brain metastases in ovarian cancer reporting survival related to treatment modality. Survival was analyzed according to treatment regimens involving (1) some form of surgical excision or gamma-knife radiation with or without other modalities, (2) other modalities without surgery or gamma-knife radiation, or (3) palliation only.
Twelve patients (mean age 56 years) with detailed treatment/outcome data were included; five were from China, four from Canada, and three from India. Median time from diagnosis of ovarian cancer to brain metastasis was 19 months (range 10 to 37 months), and overall median survival time from diagnosis of ovarian cancer was 38 months (13 to 82 months). Median survival time from diagnosis of brain metastasis was 17 months (1 to 45 months). Among patients who had multimodal treatment including gamma-knife radiotherapy or surgical excision, the median survival time after the identification of brain metastasis was 25.6 months, compared with 6.0 months in patients whose treatment did not include this type of focused localized modality (P = 0.006). Analysis of 20 studies also indicated that use of gamma-knife radiotherapy and excisional surgery in multi-modal treatment resulted in improved median survival interval (25 months vs. 6.0 months, P < 0.001).
In the subset of patients with brain metastases from ovarian cancer, prolonged survival may result from use of multidisciplinary therapy, particularly if metastases are amenable to localized treatments such as gamma-knife radiotherapy and surgical excision.
探讨治疗方式对上皮性卵巢癌脑转移患者生存的影响。
我们对三个国家（加拿大、中国和印度）机构治疗的卵巢癌脑转移病例进行了回顾性研究，并检索了有关卵巢癌脑转移且报告了与治疗方式相关生存情况的研究。根据治疗方案分析生存情况，治疗方案包括：（1）某种形式的手术切除或伽玛刀放疗，联合或不联合其他方式；（2）不包括手术或伽玛刀放疗的其他方式；（3）仅姑息治疗。
纳入了12例有详细治疗/结局数据的患者（平均年龄56岁）；5例来自中国，4例来自加拿大，3例来自印度。从卵巢癌诊断到脑转移的中位时间为19个月（范围10至37个月），从卵巢癌诊断开始的总体中位生存时间为38个月（13至82个月）。从脑转移诊断开始的中位生存时间为17个月（1至45个月）。在接受包括伽玛刀放疗或手术切除的多模式治疗的患者中，脑转移确诊后的中位生存时间为25.6个月，而治疗不包括这种聚焦局部治疗方式的患者为6.0个月（P = 0.006）。对20项研究的分析还表明，在多模式治疗中使用伽玛刀放疗和切除手术可提高中位生存间隔（25个月对6.0个月，P < 0.001）。
在卵巢癌脑转移患者亚组中，采用多学科治疗可能会延长生存期，特别是当转移灶适合进行局部治疗（如伽玛刀放疗和手术切除）时。
