国际妇产科学杂志

国际妇产科学杂志 ›› 2025, Vol. 52 ›› Issue (1): 23-27.doi: 10.12280/gjfckx.20240746

• 妇科肿瘤研究:论著 • 上一篇    下一篇

卵巢上皮性癌脑转移20例临床分析

李楠, 彭二玄, 刘风花   

  1. 450000 郑州大学附属肿瘤医院/河南省肿瘤医院妇科
  • 收稿日期:2024-08-19 出版日期:2025-02-15 发布日期:2025-02-14

Clinical Analysis of 20 Cases of Brain Metastasis from Ovarian Epithelial Carcinoma

LI Nan, PENG Er-xuan, LIU Feng-hua   

  1. Department of Gynecology, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou 450000, China
  • Received:2024-08-19 Published:2025-02-15 Online:2025-02-14

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摘要：

目的：探讨卵巢上皮性癌脑转移患者的临床特征、治疗方式及预后影响因素。方法：回顾性分析2010年9月—2022年3月就诊于郑州大学附属肿瘤医院的20例卵巢上皮性癌脑转移患者的临床资料。分析患者的临床特征、治疗方式及预后数据。结果：20例患者确诊卵巢癌时平均年龄（53.5±9.6）岁，诊断脑转移时平均年龄（55.7±10.4）岁，确诊卵巢癌至诊断脑转移的中位时间为25（2~116）个月。卵巢浆液性癌15例（75%），透明细胞癌2例（10%），15例（75%）患者为Ⅲ~Ⅳ期，19例（95%）患者接受了肿瘤细胞减灭术，初始手术后残余肿瘤直径≥1 cm的患者13例（65%）。诊断脑转移时铂敏感者12例（60%），有临床症状者16例（80%），最常见的症状是头痛（7例）、眩晕（6例）。6例（30%）患者接受单模式治疗，14例（70%）患者接受多模式治疗。患者脑转移后的中位生存时间为12（1~80）个月。单因素Cox回归分析显示，卵巢透明细胞癌、初始手术后残余肿瘤直径≥1 cm、诊断脑转移时铂耐药、脑转移时颅外肿瘤处于进展状态可增加患者死亡风险；多模式治疗可降低患者死亡风险。多因素Cox回归分析结果显示诊断脑转移时铂耐药是影响患者生存的独立危险因素。结论：卵巢上皮性癌脑转移患者的预后受到多种因素的影响，多模式治疗策略可减小死亡风险。

关键词: 卵巢肿瘤, 卵巢上皮癌, 肿瘤转移, 比例危险度模型, 脑转移

Abstract:

Objective: To investigate the clinical characteristics, treatment modalities and prognostic factors affecting patients with brain metastasis from ovarian epithelial cancer. Methods: A retrospective analysis was conducted on the clinical data of 20 patients with brain metastasis from epithelial ovarian cancer treated in the Affiliated Cancer Hospital of Zhengzhou University from September 2010 to March 2022. The clinical characteristics, treatment modalities and prognostic data of the patients were analyzed. Results: The average age of the 20 patients was(53.5±9.6) years old at the time of diagnosis of ovarian cancer and (55.7±10.4) years old at the time of diagnosis of brain metastasis, and the median time between diagnosis of ovarian cancer and diagnosis of brain metastasis was 25 (2~116) months. 15 cases (75%) of ovarian plasma carcinoma and 2 cases (10%) of clear cell carcinoma were diagnosed, 15 cases (75%) were stage Ⅲ-Ⅳ, 19 cases (95%) underwent tumor cytoreduction, and 13 cases (65%) had residual tumor ≥1 cm in diameter after the initial surgery. Platinum sensitivity at the time of diagnosis of brain metastases was observed in 12 patients (60%), and clinical symptoms were observed in 16 patients (80%), with the most common symptoms being headache (7 cases) and vertigo (6 cases). 6 patients (30%) received single-modality therapy, and 14 patients (70%) received multimodal therapy. The median survival time of patients after brain metastasis was 12 (1~80) months. Univariate Cox regression analysis showed that clear cell carcinoma of the ovary, residual tumor≥1 cm in diameter after initial surgery, platinum resistance at the time of diagnosis of brain metastases, and extracranial tumors at progression at the time of brain metastases increased the risk of death; multimodal treatment reduced the risk of death. The results of multivariate Cox regression analysis showed that platinum resistance at the time of diagnosis of brain metastasis was an independent risk factor affecting patient survival. Conclusions: The prognosis of patients with brain metastases from ovarian epithelial cancer is affected by multiple factors, and multimodal treatment strategies can reduce the risk of death.

Key words: Ovarian neoplasms, Carcinoma, ovarian epithelial, Neoplasm metastasis, Proportional hazards models, Brain metastasis