Alizzi Zena, Roxburgh Patricia, Cartwright Douglas, McLaren Alistair, Park Sarah, Jones Rachel, Greening Semini, Hudson Emma, Green Clare, Gray Simon, Khalique Saira, Karteris Emmanouil, Hall Marcia
Mount Vernon Cancer Centre, Rickmansworth Road, Northwood HA6 2RN, UK.
Beatson West of Scotland Cancer Centre, University of Glasgow, Glasgow G12 0YN, UK.
J Clin Med. 2023 Mar 25;12(7):2497. doi: 10.3390/jcm12072497.
The incidence of brain metastases (BM) in patients with epithelial ovarian cancer (EOC) is low: 0.3-11%. The onset of BM has been regarded as a late event with limited treatment options and poor prognosis. This retrospective case series aims to explore the current management strategies with particular emphasis on the use of PARP inhibitors and outcomes, as well as identification of other prognostic indicators.
A total of 39 ovarian cancer patients with brain metastases were identified from eight cancer centres in the UK. Clinical characteristics, details of management, and survival data were collected.
A total of 14/39 had BM as their first site of relapse. The majority (29 patients) received systemic treatments in addition to local radiotherapy (RT)/surgery. Nineteen patients had mutations (one somatic), one had a mutation, and eighteen were BRCA wild type; one was unknown. A total of 14/39 patients received maintenance PARP inhibitors. As is well known, patients who received PARPi had consistently better outcomes. This was no different for those who received PARPi as part of the management of their BM. Platinum sensitivity and receiving more than one modality of therapy (e.g., radiation +/- chemotherapy and PARPi) for BM were also good prognostic indicators. Median PFS/OS for those treated with chemotherapy and either RT or surgery, then PARP inhibitor maintenance, have not been reached after a median of 33 months follow up.
As with abdominal relapse, maintenance treatment with PARP inhibitors also has a valuable role in managing BMs in EOC patients.
上皮性卵巢癌（EOC）患者发生脑转移（BM）的发生率较低：为0.3%-11%。脑转移的发生被视为晚期事件，治疗选择有限且预后较差。本回顾性病例系列旨在探讨当前的管理策略，尤其侧重于PARP抑制剂的使用及其疗效，以及其他预后指标的识别。
从英国的八个癌症中心共识别出39例发生脑转移的卵巢癌患者。收集了临床特征、管理细节和生存数据。
共有14/39例患者的脑转移为首次复发部位。大多数患者（29例）除接受局部放疗（RT）/手术外还接受了全身治疗。19例患者有 突变（1例为体细胞突变），1例有 突变，18例为BRCA野生型；1例情况不明。共有14/39例患者接受了PARP抑制剂维持治疗。众所周知，接受PARPi治疗的患者始终有更好的疗效。对于那些在脑转移管理中接受PARPi治疗的患者来说也是如此。铂类敏感性以及针对脑转移接受不止一种治疗方式（例如放疗+/-化疗和PARPi）也是良好的预后指标。接受化疗以及放疗或手术，然后接受PARP抑制剂维持治疗的患者，在中位随访33个月后，中位无进展生存期/总生存期尚未达到。
与腹部复发一样，PARP抑制剂维持治疗在EOC患者脑转移的管理中也具有重要作用。
