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喉鳞状细胞癌脑转移的预后因素:病例报告与文献复习

Prognostic factors in brain metastases from laryngeal squamous cell carcinoma: Case report and review.

作者信息

Montano Nicola, Rapisarda Alessandro, Pignotti Fabrizio, Gessi Marco

机构信息

Department of Neurosurgery, Catholic University, Rome, Italy.

Department of Pathology, Catholic University, Rome, Italy.

出版信息

Surg Neurol Int. 2018 Sep 4;9:179. doi: 10.4103/sni.sni_141_18. eCollection 2018.

Abstract

BACKGROUND

Brain metastases from laryngeal squamous cell carcinoma (SCC) are rare, and there are no standardized treatments. Here we reported on a case of brain metastasis from laryngeal SCC and performed a literature review on these cases. Moreover, by plotting Kaplan-Meier curves, we carried out a survival analysis to provide an estimation of overall survival (OS) and to find possible prognostic factors.

CASE DESCRIPTION

A 65-year-old male was admitted to our department with a large left occipital lesion. Three years ago, the patient had undergone total laryngectomy with bilateral neck dissection with a diagnosis of a poor differentiated SCC. The occipital lesion was totally removed. A diagnosis of a brain metastasis from laryngeal SCC was made. The patient was submitted to adjuvant chemotherapy and radiation therapy. He is in good clinical conditions at 7-month follow-up with a still ongoing chemotherapy. From survival analysis, we have found that surgery and/or radiochemotherapy increase the OS of these patients compared with untreated cases. Moreover, Karnofsky performance status (KPS) score ≥70 and recursive partitioning analysis (RPA) classes I and II were associated with better OS in these patients.

CONCLUSION

Brain metastases from laryngeal SCC are rare. This is the first study in which a survival analysis of these cases has been performed. Surgery and/or radio-chemotherapy increase the survival of these patients compared with untreated cases. Moreover, KPS score and RPA class affect the outcome of these patients.

摘要

背景

喉鳞状细胞癌(SCC)脑转移罕见,且尚无标准化治疗方案。在此,我们报告1例喉SCC脑转移病例,并对这些病例进行文献综述。此外,通过绘制Kaplan-Meier曲线,我们进行了生存分析,以评估总生存期(OS)并寻找可能的预后因素。

病例描述

一名65岁男性因左侧枕叶巨大病变入住我科。3年前,该患者因诊断为低分化SCC接受了全喉切除术及双侧颈清扫术。枕叶病变被完全切除。诊断为喉SCC脑转移。该患者接受了辅助化疗和放疗。在7个月的随访中,他临床状况良好,化疗仍在进行。通过生存分析,我们发现与未治疗的病例相比,手术和/或放化疗可提高这些患者的OS。此外,卡诺夫斯基功能状态(KPS)评分≥70以及递归分区分析(RPA)I类和II类与这些患者更好的OS相关。

结论

喉SCC脑转移罕见。这是首次对这些病例进行生存分析的研究。与未治疗的病例相比,手术和/或放化疗可提高这些患者的生存率。此外,KPS评分和RPA类别影响这些患者的预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d1a6/6130151/ee68a9b2071a/SNI-9-179-g001.jpg

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