Ghosh-Laskar Sarbani, Agarwal Jai Prakash, Yathiraj Prahlad H, Tanawade Prasad, Panday Rajendra, Gupta Tejpal, Budrukkar Ashwini, Murthy Vedang
Department of Radiation Oncology, Tata Memorial Hospital, Parel, Mumbai, Maharashtra, India.
Department of Radiation Oncology, Tata Memorial Center, Mumbai, Maharashtra, India.
J Cancer Res Ther. 2016 Jul-Sep;12(3):1160-1163. doi: 10.4103/0973-1482.184525.
Brain metastasis from primary head and neck squamous cell carcinoma (HNSCC) is infrequent and probably under-reported thereby leading to paucity of information.
Archives of two institutes in India were studied from 2005 to 2013 and relevant information regarding patient demographics, treatment details, and follow-up was obtained for patients having brain metastasis (BM) from HNSCC. Data were analyzed using SPSS software version 20 (IBM Corporation, NY, USA).
Metastasis to the brain was detected in 17 patients with an HNSCC primary. The median age for diagnosis of index primary was 55 years (range (R) - 32-71 years) with 88% (15/17) being male. Oral cavity was the most common site of primary disease with 35% (6/17) followed by larynx (24%), oropharynx (18%), and hypopharynx (18%). The median stage at presentation was IVA (47%) and two (12%) were metastatic to the brain at presentation. Human papillomavirus analysis was not available for any of the patients. Neurological symptoms were complained of in 94% patients. The median BM-free-interval was 15 months (R - 1-67 months, SE ± 5.2). While 88% had multiple brain metastases, 82% also had extracranial metastasis and in 53% of patients, the index primary was not controlled. The median overall survival of all patients after the development of BM was 2 months (R - 0.5-6 months, SE ± 0.4).
BM in HNSCC is mostly multiple, associated with extracranial metastasis and can occur in patients without locoregional relapse or residual disease and carries a dismal outcome.
原发性头颈部鳞状细胞癌（HNSCC）发生脑转移并不常见，可能存在报告不足的情况，从而导致相关信息匮乏。
对印度两家机构2005年至2013年的档案进行研究，获取HNSCC脑转移（BM）患者的人口统计学信息、治疗细节及随访情况。使用SPSS 20软件（美国纽约IBM公司）进行数据分析。
17例原发性HNSCC患者被检测出脑转移。原发灶诊断的中位年龄为55岁（范围32 - 71岁），88%（15/17）为男性。口腔是最常见的原发疾病部位，占35%（6/17），其次是喉（24%）、口咽（18%）和下咽（18%）。就诊时的中位分期为IVA期（47%），2例（12%）就诊时已发生脑转移。所有患者均未进行人乳头瘤病毒分析。94%的患者有神经症状主诉。无BM间期的中位时间为15个月（范围1 - 67个月，标准误±5.2）。88%的患者有多发脑转移，82%的患者同时有颅外转移，53%的患者原发灶未得到控制。发生BM后所有患者的中位总生存期为2个月（范围0.5 - 6个月，标准误±0.4）。
HNSCC的BM大多为多发，与颅外转移相关，可发生于无局部区域复发或残留疾病的患者，预后较差。
