Wroński M, Arbit E, Burt M, Perino G, Galicich J H, Brennan M F
Neurosurgery Service, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA.
Ann Surg Oncol. 1995 Sep;2(5):392-9. doi: 10.1007/BF02306371.
Brain metastases from sarcoma are rare, and data concerning the treatment and results of therapy are sparse.
We retrospectively reviewed 25 patients with brain metastases from sarcoma of skeletal or soft-tissue origin, surgically treated in a single institution during 20 years.
In 18 patients the brain lesion was located supratentorially, and in 7 patients infratentorially. Median age at brain metastasis diagnosis was 25 years. Median time from primary diagnosis to diagnosis of brain metastasis was 26.7 months. Lung metastases were present in 19 patients and in 8 patients they were synchronous with the brain lesion. Pulmonary metastases were resected in 12 patients (48% of total, and 63% of those with pulmonary lesions). The overall median survival from diagnosis of the primary sarcoma was 38 months and from craniotomy was 7 months. The presence or absence of lung lesions did not alter the median survival as calculated from diagnosis of brain metastasis. Overall percent survival was 40% at 1 year and 16% at 2 years.
Because brain metastases from sarcoma are refractory to alternative treatment, surgical excision is indicated when feasible. Brain metastases from sarcoma are uncommon, usually occurring with or after lung metastasis. Long-term survival is possible in some patients.
肉瘤脑转移罕见，有关治疗及治疗结果的数据稀少。
我们回顾性分析了20年间在单一机构接受手术治疗的25例骨骼或软组织来源肉瘤脑转移患者。
18例患者脑病灶位于幕上，7例位于幕下。脑转移诊断时的中位年龄为25岁。从原发诊断到脑转移诊断的中位时间为26.7个月。19例患者存在肺转移，其中8例肺转移与脑病灶同时出现。12例患者（占总数的48%，占伴有肺部病灶患者的63%）接受了肺转移瘤切除术。从原发肉瘤诊断开始计算的总体中位生存期为38个月，开颅术后为7个月。有无肺部病灶并不改变从脑转移诊断计算出的中位生存期。1年时总体生存率为40%，2年时为16%。
由于肉瘤脑转移对其他治疗方法难治，可行时应进行手术切除。肉瘤脑转移不常见，通常在肺转移时或之后发生。部分患者有可能长期生存。
