Kurishima Koichi, Homma Shinsuke, Kagohashi Katsunori, Miyazaki Kunihiko, Kawaguchi Mio, Satoh Hiroaki, Hizawa Nobuyuki
Division of Respiratory Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
Division of Respiratory Medicine, Mito Medical Center, University of Tsukuba, Mito, Ibaraki 10-0015, Japan.
Mol Clin Oncol. 2014 Mar;2(2):305-307. doi: 10.3892/mco.2013.236. Epub 2013 Dec 31.
The brain is one of the most common sites of metastasis of small-cell lung cancer (SCLC). In this study, we reported 6 cases with isolated brain relapse of SCLC ≥1 year after the completion of the initial treatment for SCLC. Of the 6 patients, 2 had a solitary brain metastasis and 4 had ≥2 brain metastatic sites. The metastases were identified during a regular check-up computed tomography (CT) scan and were successfully treated. The median interval from the initial diagnosis to the development of brain metastasis was 16 months (range, 13-30 months). All patients received whole-brain irradiation and achieved a complete response. Only one patient developed disturbances of the higher cerebral function. The median interval from whole-brain irradiation to death or last follow-up was 33 months (range, 8-90 months). To the best of our knowledge, these are the first reported cases with isolated brain relapse of SCLC. Although a rare finding, clinicians should be alert on the possibility of such recurrence, particularly in patients who refused prophylactic cranial irradiation.
脑是小细胞肺癌（SCLC）最常见的转移部位之一。在本研究中，我们报告了6例在SCLC初始治疗完成后≥1年出现孤立性脑复发的病例。6例患者中，2例有孤立性脑转移，4例有≥2个脑转移部位。这些转移灶在定期的计算机断层扫描（CT）检查中被发现并得到成功治疗。从初始诊断到发生脑转移的中位间隔时间为16个月（范围13 - 30个月）。所有患者均接受了全脑照射并获得完全缓解。仅1例患者出现高级脑功能障碍。从全脑照射到死亡或最后一次随访的中位间隔时间为33个月（范围8 - 90个月）。据我们所知，这些是首次报道的SCLC孤立性脑复发病例。尽管这是一个罕见的发现，但临床医生应警惕这种复发的可能性，尤其是对于拒绝预防性颅脑照射的患者。
