中华妇产科杂志
中華婦產科雜誌
중화부산과잡지
CHINESE JOUNAL OF OBSTETRICS AND GYNECOLOGY
2012年
3期
191-195
,共5页
袁光文%吴令英%黄曼妮%姚洪文
袁光文%吳令英%黃曼妮%姚洪文
원광문%오령영%황만니%요홍문
脑肿瘤%肿瘤转移%预后%子宫肿瘤%卵巢肿瘤
腦腫瘤%腫瘤轉移%預後%子宮腫瘤%卵巢腫瘤
뇌종류%종류전이%예후%자궁종류%란소종류
Brain neoplasms%Neoplasm metastasis%Prognosis%Uterine neoplasms%Ovarian neoplasms
目的 探讨妇科恶性肿瘤脑转移患者的临床特点、治疗方法及预后影响因素.方法 回顾性分析1999年1月至2009年1月收治的25例妇科恶性肿瘤脑转移患者的临床资料,比较各种治疗方法的疗效及预后影响因素.结果 25例患者的原发肿瘤14例为卵巢恶性肿瘤,6例为宫颈鳞癌,5例为子宫恶性肿瘤.颅内转移病灶为单发病灶者有7例(28％,7/25).在发现脑转移病灶的同时有18例(72％,18/25)合并有颅外病灶.诊断脑转移时患者的Karnofsky评分有14例≥70分,占56％( 14/25)；有13例(52％,13/25)为病理低分化.25例患者发生脑转移后的中位生存时间为7.3个月.治疗方式:接受单一治疗(放疗或化疗)的患者有5例,平均生存时间为4.0个月(0.5 ～9.5个月)；16例患者接受了联合治疗,其中3例接受了包含手术的联合治疗,平均生存时间8.4个月(4.1 ～13.4个月),有13例接受了放疗+化疗,平均生存时间为14.2个月(4.3 ～58.1个月)；4例患者仅接受姑息对症支持治疗,其生存时间仅为0.1 ～1.0个月.多因素分析结果显示,Karnofsky评分、是否合并颅外病灶及治疗方式是妇科恶性肿瘤脑转移患者预后的独立影响因素(P＜0.05).结论 妇科恶性肿瘤脑转移的预后差,发生率较低.治疗方面采用联合治疗能够获得相对较好的疗效.
目的 探討婦科噁性腫瘤腦轉移患者的臨床特點、治療方法及預後影響因素.方法 迴顧性分析1999年1月至2009年1月收治的25例婦科噁性腫瘤腦轉移患者的臨床資料,比較各種治療方法的療效及預後影響因素.結果 25例患者的原髮腫瘤14例為卵巢噁性腫瘤,6例為宮頸鱗癌,5例為子宮噁性腫瘤.顱內轉移病竈為單髮病竈者有7例(28％,7/25).在髮現腦轉移病竈的同時有18例(72％,18/25)閤併有顱外病竈.診斷腦轉移時患者的Karnofsky評分有14例≥70分,佔56％( 14/25)；有13例(52％,13/25)為病理低分化.25例患者髮生腦轉移後的中位生存時間為7.3箇月.治療方式:接受單一治療(放療或化療)的患者有5例,平均生存時間為4.0箇月(0.5 ～9.5箇月)；16例患者接受瞭聯閤治療,其中3例接受瞭包含手術的聯閤治療,平均生存時間8.4箇月(4.1 ～13.4箇月),有13例接受瞭放療+化療,平均生存時間為14.2箇月(4.3 ～58.1箇月)；4例患者僅接受姑息對癥支持治療,其生存時間僅為0.1 ～1.0箇月.多因素分析結果顯示,Karnofsky評分、是否閤併顱外病竈及治療方式是婦科噁性腫瘤腦轉移患者預後的獨立影響因素(P＜0.05).結論 婦科噁性腫瘤腦轉移的預後差,髮生率較低.治療方麵採用聯閤治療能夠穫得相對較好的療效.
목적 탐토부과악성종류뇌전이환자적림상특점、치료방법급예후영향인소.방법 회고성분석1999년1월지2009년1월수치적25례부과악성종류뇌전이환자적림상자료,비교각충치료방법적료효급예후영향인소.결과 25례환자적원발종류14례위란소악성종류,6례위궁경린암,5례위자궁악성종류.로내전이병조위단발병조자유7례(28％,7/25).재발현뇌전이병조적동시유18례(72％,18/25)합병유로외병조.진단뇌전이시환자적Karnofsky평분유14례≥70분,점56％( 14/25)；유13례(52％,13/25)위병리저분화.25례환자발생뇌전이후적중위생존시간위7.3개월.치료방식:접수단일치료(방료혹화료)적환자유5례,평균생존시간위4.0개월(0.5 ～9.5개월)；16례환자접수료연합치료,기중3례접수료포함수술적연합치료,평균생존시간8.4개월(4.1 ～13.4개월),유13례접수료방료+화료,평균생존시간위14.2개월(4.3 ～58.1개월)；4례환자부접수고식대증지지치료,기생존시간부위0.1 ～1.0개월.다인소분석결과현시,Karnofsky평분、시부합병로외병조급치료방식시부과악성종류뇌전이환자예후적독립영향인소(P＜0.05).결론 부과악성종류뇌전이적예후차,발생솔교저.치료방면채용연합치료능구획득상대교호적료효.
Objective To discuss the clinical characteristics,treatment and prognostic factors of brain metastasis from gynecological cancers.Methods Clinical records of 25 brain metastasis patients from gynecological cancers admitted from January 1999 to January 2009 were reviewed retrospectively.The curative effects of different treatments were compared.The prognostic factors were determined using the Cox regression model.Results There were 14 cases ovarian malignant tumor,6 cases cervical carcinoma and 5 cases uterine malignant tumor.Seven cases (28％,7/25 ) had solitary metastatic lesion in the brain.Extracranial metastases were detected in 18 cases (72％,18/25 ).Five patients only received one kind of treatment,and the mean survival time was 4.0 months (0.5 to 9.5 months).Sixteen patients received combined treatment,3 of them received combined treatment including surgery,and the mean survival time was 8.4 months (4.1 to 13.4 months) ; 13 of them received chemotherapy and radiotherapy,and the mean survival time was 14.2 months (4.3 to 58.1 months).Four patients received only palliative supportive care,and the survival time was only 0.1 to 1.0 month.The Cox regression model showed that Karnofsky performance status scale,with or without extracranial metastases and the treatment method were the independent prognostic factors of brain metastasis from gynecological cancers ( P ＜ 0.05 ).Conclusion The incidence of brain metastasis from gynecological cancers is low and the prognosis is very poor.Combined treatments may get better effects.
