卵巢上皮性癌脑转移15例临床分析  

Brain metastases from epithelial ovarian carcinoma:clinical analysis of 15 cases

作　　者：李文娟[1,2] 成宁海[1] 王瑾晖[1] 黄惠芳[1] LI Wen-juan;CHENG Ning-hai;WANG Jin-hui;HUANG Hui-fang(Department of Gynecology and Obstetrics, Peking Union Medical College Hospital, Beijing 100730,China;Department of Gynecology, the People' s Hospital of Liaoning Province, Liaoning Shenyang 110016, China)

机构地区：[1]中国医学科学院北京协和医学院北京协和医院妇产科,北京100730 [2]辽宁省人民医院妇科,辽宁沈阳110016

出　　处：《中国医刊》2019年第4期414-418,共5页Chinese Journal of Medicine

摘　　要：目的探讨卵巢上皮性癌脑转移的治疗方法和预后相关因素。方法回顾性分析北京协和医院2007年3月至2017年3月收治的15例卵巢上皮性癌脑转移患者的临床资料,同时复习相关文献,分析伽马刀+化疗治疗以及其他治疗方法(手术、全脑放疗、化疗)与患者预后的关系。结果本组卵巢上皮性癌脑转移患者的中位发病年龄为56岁,其中早期患者(Ⅰ—Ⅱ期)2例,晚期患者(Ⅲ—Ⅳ期)13例;以浆液性腺癌为主(11例)。脑转移为单发者4例。未治疗者5例,伽马刀+化疗治疗者4例,其他治疗(手术、全脑放疗、化疗)6例。诊断脑转移后中位生存时间为16个月(1～78个月),诊断卵巢癌后中位总生存时间为42个月(10～122个月)。以脑转移后生存时间为因变量进行单因素分析发现,Kamofsky评分≥70分、伽马刀治疗与脑转移后生存时间有相关性(P<0.05)。以总生存时间为因变量进行单因素分析发现,Kamofsky评分≥70分与总生存时间有相关性(P<0.05)。结论卵巢上皮性癌脑转移患者预后差,治疗原则为提高患者生活质量,并延长生存时间。除了传统手术、放疗和化疗以外,伽马刀治疗卵巢上皮性癌脑转移安全有效,患者生活质量较好,并可显著延长患者脑转移后的生存时间。Objective To explore the treatment and prognostic factors of brain metastases from epithelial ovarian cancer. Method The medical records of 15 cases with brain metastases from epithelial ovarian carcinoma treated in Peking Union Medical College Hospital between March 2007 and March 2017 were analyzed retrospectively.At the same time,review the relevant documents and analyze the correlation between gamma knife radiosurgery and chemotherapy,other treatment(surgery, whole brain radiotherapy, chemotherapy)and prognosis. Result The median age of brain metastasis from epithelial ovarian cancer was 56 years old, of which early patients(stageⅠ-Ⅱ) were 2 cases, and advanced patients(Ⅲ-Ⅳ) were 13 cases. Serous adenocarcinoma was the prevalent cell type(11/15).4 patients were isolated brain metastasis. There were 5 untreated cases, 4 cases of gamma knife radiosurgery and chemotherapy, and 6 cases of other treatment(surgery, whole brain radiotherapy, chemotherapy). The median survival from the diagnosis of brain metastases was 16 months( range, 1-78 months).The median survival from the diagnosis of ovarian cancer was 42 months( range,10-122 months). Through single factor analysis of the dependent variable of the patients’ post-brain-metastasis survival, the Kamofsky score ≥70 and gamma knife radiosurgery were found to be related to post-brain-metastasis survival(P<0.05). Through single factor analysis of the dependent variable of the patients’ overall survival from the diagnosis of ovarian cancer, the Kamofsky score ≥70 were found to be related to the overall survival from the diagnosis of ovarian cancer(P<0.05). Conclusion The gamma knife radiosurgery is safe and effective treatment besides traditional surgery, radiotherapy and chemotherapy, which can signi?cantly improve the survival from the diagnosis of brain metastasis from ovarian epithelial carcinoma.

关 键 词：卵巢上皮性癌 脑转移 伽马刀治疗 预后 

分 类 号：R737.31[医药卫生—肿瘤]