Rahnea-Nita Roxana-Andreea, Rebegea Laura-Florentina, Nechifor Alexandru, Mareș Cristian, Toma Radu-Valeriu, Stoian Alexandru-Rares, Ciuhu Anda-Natalia, Andronache Liliana-Florina, Constantin Georgiana Bianca, Rahnea-Nita Gabriela
The Clinical Department, The Faculty of Medicine, The University of Medicine and Pharmacy "Carol Davila", 050474 Bucharest, Romania.
The Oncology-Palliative Care Department, "Sf. Luca" Chronic Disease Hospital, 041915 Bucharest, Romania.
J Clin Med. 2023 Aug 27;12(17):5579. doi: 10.3390/jcm12175579.
Prostate cancer has no initial clinical manifestation in the case of brain metastases since they are asymptomatic at first. This is why there is a high risk for clinicians to overlook these lesions, and they are often confused with other diseases. With all the improvements in diagnostic technological methods, which allow the early detection of lesions, and the progress in terms of systemic therapy associated with increased survival, an increase in incidence has also been noticed.
We report the case of a 64-year-old patient who presented himself to the Oncology Department of "St. Luca" Chronic Disease Hospital in Bucharest in November 2011 and received the following diagnosis: biopsied prostate neoplasm, local-regionally advanced, pelvic lymph node metastases.
After receiving complex oncological treatment, this patient represents a rare case of long-term progression-free survival (15 years).
This case has some particularities. According to the literature data, survival with metastatic prostate cancer is approximately 21 months, and cerebral metastases are found in only 2% of prostate cancer cases. This case is one of the few cases in the specialty literature that benefited from all therapeutic sequences; namely, total androgenic blockade, docetaxel, abiraterone, enzalutamide, and cabazitaxel.
Brain metastases are an unfavorable prognostic factor in prostate cancer. The therapeutic options developed in recent years allow the improvement of survival.
前列腺癌发生脑转移时最初并无临床表现，因为一开始这些转移灶是无症状的。这就是临床医生很容易忽略这些病灶，且它们常与其他疾病相混淆的原因。随着诊断技术方法的不断改进，能够实现病灶的早期检测，以及全身治疗方面取得进展，患者生存率提高，脑转移的发生率也有所上升。
我们报告了一例64岁患者的病例，该患者于2011年11月前往布加勒斯特“圣卢卡”慢性病医院肿瘤科就诊，诊断结果如下：经活检确诊为前列腺肿瘤，局部区域进展期，伴有盆腔淋巴结转移。
在接受综合肿瘤治疗后，该患者成为长期无进展生存（15年）的罕见病例。
该病例有一些特殊之处。根据文献数据，转移性前列腺癌患者的生存期约为21个月，仅2%的前列腺癌病例会出现脑转移。该病例是专业文献中少数从所有治疗方案中获益的病例之一，这些治疗方案包括全雄激素阻断、多西他赛、阿比特龙、恩杂鲁胺和卡巴他赛。
脑转移是前列腺癌的不良预后因素。近年来开发出的治疗方案可提高患者生存率。
