Kato Mayumi Kobayashi, Tanase Yasuhito, Uno Masaya, Ishikawa Mitsuya, Kato Tomoyasu
Department of Gynecology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan.
Cancers (Basel). 2021 Jan 29;13(3):519. doi: 10.3390/cancers13030519.
Reports on brain metastases (BMs) from uterine cervical carcinoma (CC) and uterine endometrial carcinoma (EC) have recently increased due to the development of massive databases and improvements in diagnostic procedures. This review separately investigates the prevalence, clinical characteristics, clinical presentation, diagnosis, treatment, and prognosis of BMs from CC and uterine endometrial carcinoma EC. For patients with CC, early-stage disease and poorly differentiated carcinoma lead to BMs, and elderly age, poor performance status, and multiple BMs are listed as poor prognostic factors. Advanced-stage disease and high-grade carcinoma are high-risk factors for BMs from EC, and multiple metastases and extracranial metastases, or unimodal therapies, are possibly factors indicating poor prognosis. There is no "most effective" therapy that has gained consensus for the treatment of BMs. Treatment decisions are based on clinical status, number of the metastases, tumor size, and metastases at distant organs. Surgical resection followed by adjuvant radiotherapy appears to be the best treatment approach to date. Stereotactic ablative radiation therapy has been increasingly associated with good outcomes in preserving cognitive functions. Despite treatment, patients died within 1 year after the BM diagnosis. BMs from uterine cancer remain quite rare, and the current evidence is limited; thus, further studies are needed.
由于大规模数据库的发展和诊断程序的改进，最近关于子宫颈癌（CC）和子宫内膜癌（EC）脑转移（BMs）的报告有所增加。本综述分别调查了CC和子宫内膜癌EC脑转移的患病率、临床特征、临床表现、诊断、治疗和预后。对于CC患者，早期疾病和低分化癌会导致脑转移，老年、身体状况差和多发脑转移被列为不良预后因素。晚期疾病和高级别癌是EC脑转移的高危因素，多发转移和颅外转移或单一治疗可能是预后不良的因素。目前尚无治疗脑转移的“最有效”疗法获得共识。治疗决策基于临床状况、转移灶数量、肿瘤大小和远处器官转移情况。手术切除后辅助放疗似乎是迄今为止最佳的治疗方法。立体定向消融放疗在保留认知功能方面越来越多地与良好预后相关。尽管进行了治疗，患者在脑转移诊断后1年内死亡。子宫癌脑转移仍然相当罕见，目前证据有限；因此，需要进一步研究。
