Department of Hematology-Oncology, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon.
Department of Neurosurgical Surgery, University of Ioawa, Ioawa City, IA, USA.
Future Oncol. 2019 Aug;15(23):2759-2768. doi: 10.2217/fon-2019-0108. Epub 2019 Aug 6.
Cancer of unknown primary accounts for 3-5% of all cancers for which an adequate investigation does not identify the primary tumor. The particular subset of brain metastasis in cancer of unknown primary (BMCUP) is a clinical challenge that lacks standardized diagnostic and therapeutic options. It is diagnosed predominantly in male patients in the sixth decade of age with complaints of headache, neurological dysfunction, cognitive and behavioral disturbances and seizures. The therapeutic approach to patients with BMCUP relies on local control and systemic treatment. Surgery or stereotactic radiosurgery and/or whole brain radiation therapy seems to be the cornerstone of the treatment approach to BMCUP. Systemic therapy remains essential as cancers of unknown primary are conceptually metastatic tumors. The benefits of chemotherapy were disappointing whereas those of targeted therapies and immune checkpoint inhibitors remain to be evaluated. In this Review, we address the advances in the diagnosis and treatment of BMCUP.
原发灶不明癌症占所有癌症的 3-5%，对这些癌症进行充分的检查仍无法确定其原发肿瘤。原发灶不明癌症脑转移（BMCUP）是一个临床挑战，缺乏标准化的诊断和治疗选择。它主要发生在 60 岁左右的男性患者中，症状为头痛、神经功能障碍、认知和行为障碍以及癫痫发作。BMCUP 患者的治疗方法依赖于局部控制和全身治疗。手术或立体定向放射外科手术和/或全脑放射治疗似乎是 BMCUP 治疗方法的基石。全身治疗仍然是必不可少的，因为原发灶不明癌症从概念上讲是转移性肿瘤。化疗的益处令人失望，而靶向治疗和免疫检查点抑制剂的益处仍有待评估。在这篇综述中，我们将讨论 BMCUP 的诊断和治疗进展。
